Mapping of Venous Sinus Anatomy and Occipital Bone Thickness for Safe Screw Placement in 100 patients with 46,200 Standardized Measurements Using Computed Tomography Angiography

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Marie-Jacqueline Reisener ◽  
Artine Arzani ◽  
Ichiro Okano ◽  
Stephan N. Salzmann ◽  
Colleen Rentenberger ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Venous Sinus ◽  
Occipital Bone ◽  
Screw Placement ◽  
Bone Thickness

scholarly journals Mapping occipital bone thickness using computed tomography for safe screw placement

2015 ◽  
Vol 23 (2) ◽  
pp. 254-258 ◽  
Author(s):  
Tomonori Morita ◽  
Tsuneo Takebayashi ◽  
Hiroyuki Takashima ◽  
Mitsunori Yoshimoto ◽  
Kazunori Ida ◽  
...  
Keyword(s):  
Morphological Analysis ◽  
Reference Range ◽  
Occipital Bone ◽  
Institutional Review Board ◽  
Morphological Data ◽  
Screw Placement ◽  
Female Group ◽  
Bone Thickness ◽  
Institutional Review ◽  
Neck Disease

OBJECT Safe and effective insertion of occipital bone screws requires morphological analysis of the occipital bone, which is poorly documented in the literature. The authors of this study present morphological data for determining the area of screw placement for optimal internal fixation. METHODS The subjects of this institutional review board-approved retrospective study were 105 individuals without head and neck disease who underwent CT imaging at the authors’ hospital. There were 55 males and 50 females, with a mean age of 57.1 years (range 20–91 years). Measurements using CT were taken according to a matrix of 55 points following a grid with 1-cm spacing based on the external occipital protuberance (EOP). RESULTS The maximum thickness of the occipital bone was at the level of the EOP at 16.4 mm. Areas with thicknesses > 8 mm were more frequent at the EOP and up to 2 cm in all directions, as well as up to 1 cm in all directions at a height of 1 cm inferiorly, and up to 3 cm from the EOP inferiorly. The male group tended to have a thicker occipital bone than the female group, and the differences were significant around the EOP. The ratio of the trabecular bone to the occipital bone thickness was > 30% in the central region. At positions more than 2 cm laterally, the ratio was < 15%, and the ratio gradually decreased further laterally. CONCLUSIONS Screws that are 8 mm long can be placed in the area extending 2 cm laterally from the EOP at the level of the superior nuchal line and approximately 3 cm inferior to the center. These results suggest that it may be possible to effectively insert a screw over a wider area than the conventional reference range.

Posterior C1 Stabilization Using Superior Lateral Mass as an Entry Point in a Case With Vertebral Artery Anomaly: Technical Case Report

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. onsE246-onsE249 ◽  
Author(s):  
Jae Taek Hong ◽  
Woo Young Jang ◽  
Il Sup Kim ◽  
Seung Ho Yang ◽  
Jae Hoon Sung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Vertebral Artery ◽  
Computed Tomography Angiography ◽  
Anatomical Variations ◽  
Entry Point ◽  
Screw Placement ◽  
Lateral Mass ◽  
Starting Point ◽  
Bursting Fracture ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE: This is the first report of using the superior lateral mass as an alternative starting point for C1 posterior screw placement, demonstrating the importance of recognizing vertebral artery (VA) anomaly in deciding the surgical strategy for C1 screw placement. CLINICAL PRESENTATION: A 56-year-old man presented with severe neck pain after a fall. Imaging demonstrated an unstable bursting fracture at C4, C1-2 instability, and a subluxation at C2-3. Computed tomography angiography indicated that the persistent first intersegmental artery was located on the left side. The patient underwent anterior-posterior cervical fixation and fusion. Posterior C1 fixation was done with polyaxial screw rod construct using C1 superior lateral mass on the left side and C1 inferior lateral mass on the right side. The patient had no immediate postoperative deficits. At the 8-month follow-up examination, the patient was neurologically intact with a solid cervical fusion. CONCLUSION: The third segment of the VA is heterogeneous; therefore, preoperative radiologic studies should be performed to identify any anatomical variations. Using preoperative 3-dimensional computed tomography angiography, we can precisely identify an anomalous VA, thereby significantly reducing the risk of VA injury. To avoid significant morbidities associated with VA injury, a more optimal entry point for C1 fixation can be selected if a persistent first intersegmental artery or fenestrated VA is detected.

scholarly journals HUBUNGAN KADAR D-DIMER DENGAN AWITAN GEJALA DAN LAMA PERAWATAN PADA PENDERITA CEREBRAL VENOUS SINUS THROMBOSIS DI RSUP DR HASAN SADIKIN BANDUNG

2020 ◽  
Vol 37 (2) ◽  
Author(s):  
Lisda Amalia ◽  
Adnin Nugroho
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Length Of Stay ◽  
Computed Tomography Angiography ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
D Dimer

CORRELATION BETWEEN D-DIMER LEVEL WITH ONSET OF SYMPTOMS AND LENGTH OF STAY IN CEREBRAL VENOUS SINUS THROMBOSIS PATIENTS AT HASAN SADIKIN HOSPITAL BANDUNGABSTRACTIntroduction:Cerebral venous sinus thrombosis (CVST)is one of a cerebrovascular disease with a diverse and elusive clinical presentation. Diagnosis is often challenging due to limitation in diagnostic tools.Coagulation disorder is one of the risk factor for CVST that can be seen from D-dimer level which tends to increase in CVST patients.Aim: This study aims to determine the D-dimer leveland its correlation with onset of symptoms and length of stay in CVST patients at Hasan Sadikin Hospital, Bandung.Methods: This is a cross-sectional study. The inclusion criteria were patients at Hasan Sadikin Hospital, Bandung diagnosed as CVST, confirmed by digital subtraction angiography (DSA) or computed tomography angiography (CTA) or magnetic resonance angiography (MRA) and had blood coagulation profile in the period of January 2018-May 2019. Exclusion criteria were patients with infection or sepsis. Data were collected from the patient’s medical record. Statistical value was calculated with Spearman rank test, p value<0.05 was considered significant.Results: Forty CVST patients met the criteria. CVST mostly occurred in women (80%), the mean age were 40,75 years, and had headache as primary symptom (70%). Twenty-eight(70%) patients had increased level of D-dimer. D-dimer level had negative correlation with onset of symptoms (r=-0.319, p=0.045). However, it hadassociationwith length of stay (p=0.012).Discussion: D-dimer level in CVST patients tends to increase above normal value. D-dimer level have correlation with onset of symptoms and length of stay in CVST patients.Keywords:Cerebral venous sinus thrombosis, D-dimer level, length of stay, onset of symptomsABSTRAK                          Pendahuluan: Trombosis pada vena serebral (cerebral venous sinus thrombosis/CVST) merupakan salah satu diagnosis dalam bidang cerebrovaskular yang sulit ditegakkan karena keterbatasan alat untuk diagnosis pasti. Salah satu faktor risiko terjadinya CVST adalah kelainan koagulasi yang dapat dilihat dari kadar D-dimer yang cenderung meningkat.Tujuan: Mengetahui gambaran profil D-dimer pada penderita CVST dan hubungannya dengan awitan gejala dan lama perawatan di RSUP Dr. Hasan Sadikin, Bandung.Metode: Penelitian ini merupakan penelitian potong lintang. Kriteria inklusi yaitu pasien yang terdiagnosis CVST melalui pemeriksaan digital substraction angiography (DSA) atau computed tomography angiography (CTA) atau magnetic resonance angiography (MRA) dan memiliki profil koagulasi serta dirawat di RSUP Dr. Hasan Sadikin, Bandung pada periode Januari 2018–Mei 2019. Kriteria eksklusi yaitu pasien yang disertai infeksi atau sepsis. Data diambil dari penelusuran rekam medis pasien dan dianalisis menggunakan korelasi Spearman. Signifikansi dinyatakan bila p<0,05.Hasil: Terdapat 40 pasien CVST yang memenuhi kriteria inklusi. CVST mayoritas terjadi pada perempuan (80%), rerata usia 40,75 tahun dengan keluhan utama tersering adalah nyeri kepala (70%). Terdapat 28 pasien memiliki kadar D-dimer yang meningkat (70%). Berdasarkan analisis, kadar D-dimer memiliki hubungan negatif dengan awitan gejala pasien (r=0,319, p= 0,045). Kadar D-dimer juga memiliki hubungan dengan lama perawatan (p=0,012).Diskusi: Kadar D-dimer pada penderita CVST cenderung lebih tinggi dari nilai normal. Kadar D-dimer memiliki hubungan dengan awitan gejala dan lama perawatan pasien CVST di rumah sakit.Kata kunci: Awitan gejala, cerebral venous sinus thrombosis, kadar D-dimer, lama perawatan

Mid-aortic syndrome: computed tomography angiography depicting extensive collateral circulation in an 11-year-old patient with thoracoabdominal aortic coarctation

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Krohn ◽  
Gebauer ◽  
Hübler ◽  
Beck
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Collateral Circulation ◽  
Intestinal Ischemia ◽  
Clinical Presentation ◽  
Lower Limbs ◽  
Upper Body ◽  
Descending Aorta ◽  
Before And After ◽  
Blood Pressures

The mid-aortic syndrome is an uncommon clinical condition characterized by severe narrowing of the descending aorta, usually with involvement of its renal and visceral branches, presenting with uncontrollably elevated blood pressures of the upper body, renal and cardiac failure, intestinal ischemia, encephalopathy symptoms and claudication of the lower limbs, although clinical presentation is variable. In this article we report the case of an eleven-year-old patient with the initial diagnosis of a mid-aortic syndrome and present the computed tomography angiography pictures and reconstructions before and after surgical therapy.

Computed Tomography Angiography (CTA) Evaluation of Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 6 (2) ◽  
pp. 78-81
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Sadekur Rahman Sarkar ◽  
KM Ahasan Ahmed ◽  
Md Nazmul Kabir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Computed Tomography Angiography ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Aneurysm ◽  
Traumatic Subarachnoid Hemorrhage ◽  
One Year ◽  
Spontaneous Subarachnoid Hemorrhage

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81

Dual energy computed tomography angiography of a pulmonary embolized port catheter fragment

2011 ◽  
Vol 12 (1) ◽  
pp. 62-63 ◽  
Author(s):  
Thomas Henzler ◽  
Steffen Diehl ◽  
Susanne Jochum ◽  
Tim Sueselbeck ◽  
Stefan O Schoenberg ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Dual Energy ◽  
Port Catheter ◽  
Dual Energy Computed Tomography
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