scholarly journals External syringomyelia in longstanding benign foramen magnum tumors

2020 ◽  
Vol 11 ◽  
pp. 92
Author(s):  
Aimee Goel ◽  
Abhidha Harshad Shah ◽  
Ravikiran Vutha ◽  
Atul Goel
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Canal ◽  
Foramen Magnum ◽  
Resonance Imaging ◽  
Canal Diameter ◽  
Significant Difference ◽  
Cranial Fossa ◽  
The Mean ◽  
Pontomedullary Junction ◽  
Anterior Posterior

Background: The effect of benign foramen magnum tumours on cranial and spinal dimensions and cerebrospinal fluid (CSF) spaces is unclear. In this study, we measured alterations in cerebrospinal fluid (CSF) spaces in the spinal canal and in the posterior cranial fossa distant from the site of benign foramen magnum tumors. Methods: Twenty-nine magnetic resonance imaging scans of patients with foramen magnum tumors (8 meningiomas and 21 C2 neurinomas) were identified for radiological morphometric analysis and compared with normal control scans. The anterior-posterior distance between the pontomedullary junction and the clivus, the spinal canal diameter, spinal cord diameter, and cord-canal ratios were measured at the C6 and T2 levels. Results: The mean spinal canal diameter was significantly higher in tumor scans at both the C6 and T2 spinal levels than in controls (13.8 mm vs. 11.4 mm at C6; p<0.0001, and 12.9 mm vs. 11.9 mm at T2; P=0.01). Further, the mean cord:canal ratio was significantly lower in tumor scans at both levels (0.49 vs. 0.64 at C6; P<0.0001, and 0.45 vs. 0.54 at T2; P=0.0009). There was no significant difference in mean anteroposterior distance from the clivus to the pontomedullary junction (10.4 mm vs. 10.3 mm; P=0.91). Conclusion: In the presence of benign foramen magnum tumors, the spinal canal diameter and CSF volume in the spinal canal increased at the C6 and T2 levels, distant from the tumor site, a phenomenon we describe as “external syringomyelia”.

scholarly journals The Value of Foramen Magnum Diameters for Gender Identification Among Iranian Population

2019 ◽  
Vol 9 (4) ◽  
pp. 205-212
Author(s):  
Siamak Soltani ◽  
Kamran Aghakhani ◽  
Hanieh Saboori-Shekofte ◽  
Sahar Rismantab-Sani ◽  
Forouzan Faress ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Foramen Magnum ◽  
Transverse Diameter ◽  
Gender Identification ◽  
Cross Sectional ◽  
Men And Women ◽  
Significant Difference ◽  
Males And Females ◽  
The Mean ◽  
Anterior Posterior

Background: By assessing the size of the foramen magnum, it is possible to distinguish two genders, as well as the intergenerational interdependence of the affected individuals. The present study aimed at assessing the value of diameters of foramen magnum for gender identification among the Iranian population.Methods: This analytical comparative cross-sectional study was performed on 200 Iranian cadavers (100 men and 100 women) referred to Kahrizak Autopsy Hall in Tehran between 2017 and 2018. In each case, the foramen magnum was measured by observation and its parameters were measured in a longitudinal anteroposterior and transverse diameter, using a calibrated caliper.Results: The Mean±SD anterior-posterior diameter of the foramen magnum in men and women were 35.59±0.49 mm and 33.90±1.07 mm, respectively, which was significantly higher in men (P<0.001). Similarly, the Mean±SD transverse diameter of the foramen magnum in males and females was 29.49±0.56 mm and 28.5±0.50 mm, respectively, which was significantly higher in men (P<0.001). Based on the area analysis under the Receiver Operating Characteristic (ROC) curve, the anterior-posterior and transverse diameters of the foramen magnum had a high value in the differentiation of the male and female genders (AUC=0.953 and 0.896, respectively, P<0.001). The Mean±SD foramen magnum index in men and women was 84.15±3.02 and 82.87±1.95, respectively, which had a significant difference between the two genders.Conclusion: Given that the anterior-posterior and transverse diameters of the foramen magnum in Iranian men are far more than Iranian women, these diameters can be used to distinguish between the two genders in the precise legal field.

Complete posterior cranial vault distraction osteogenesis to correct Chiari malformation type I associated with craniosynostosis

2021 ◽  
pp. 1-7
Keyword(s):  
Foramen Magnum ◽  
Posterior Cranial Fossa ◽  
Type I ◽  
Intracranial Volume ◽  
Tonsillar Herniation ◽  
Chiari Malformation Type I ◽  
Cerebellar Tonsillar Herniation ◽  
Cranial Fossa ◽  
The Mean ◽  
Tonsillar Descent

OBJECTIVE Posterior vault distraction osteogenesis (PVDO) is an effective tool to increase intracranial volume and expand the posterior cranial fossa. During PVDO, the authors extended osteotomy posterior to the foramen magnum to fully expand the posterior cranial fossa. The aim of this study was to investigate the efficacy of complete PVDO in posterior fossa expansion and treatment of Chiari malformation type I (CM-I) in patients with craniosynostosis. METHODS Patients with craniosynostosis who had undergone complete PVDO between January 2012 and May 2020 were reviewed retrospectively. A coronal osteotomy extending to the foramen magnum was performed and the foramen magnum was decompressed by removing its posterior rim with a 1-mm Kerrison rongeur. Four distractor devices were placed and the vector of distraction was controlled from the posterior to the inferior-posterior direction, depending on the deformity. Changes in the intracranial volume, posterior cranial fossa area, and cerebellar tonsillar descent were measured after complete PVDO by using CT and MRI. RESULTS A total of 11 patients with craniosynostosis and concurrent CM-I were included in the study. The mean age was 34.6 ± 24.0 months (continuous variables are expressed as the mean ± SD throughout). One patient had sleep apnea, which was consistent with CM-I, and another patient had a headache, which was nonspecific. The intracranial volume increased from 1179.6 ± 180.2 cm3 to 1440.6 ± 251.5 cm3 (p = 0.003; 24.5% increase compared to the preoperative volume). The posterior skull base area increased from 44.9 ± 19.3 cm2 to 72.7 ± 18.1 cm2 (p = 0.004). Cerebellar tonsillar descent decreased in all 11 patients after complete PVDO (preoperative: 10.8 ± 3.7 mm, postoperative: 2.7 ± 3.0 mm; p = 0.003). Among the 11 patients, 5 showed complete resolution of cerebellar tonsillar herniation. CONCLUSIONS Complete PVDO can more efficiently expand the posterior cranial fossa, unlike conventional methods. Moreover, it helps to relieve cerebellar tonsillar herniation. Complete PVDO is a powerful tool to increase the intracranial and posterior fossa volumes in patients with craniosynostosis and concurrent CM-I.

Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development

Neurosurgery ◽  
2016 ◽  
Vol 79 (5) ◽  
pp. 722-735 ◽  
Author(s):  
Guillaume Coll ◽  
Jean-Jacques Lemaire ◽  
Federico Di Rocco ◽  
Isabelle Barthélémy ◽  
Jean-Marc Garcier ◽  
...  
Keyword(s):  
Rapid Growth ◽  
Slow Growth ◽  
Volume Growth ◽  
Cranial Base ◽  
Foramen Magnum ◽  
Posterior Cranial Fossa ◽  
Healthy Children ◽  
Cranial Fossa ◽  
The Mean ◽  
Tomography Scan

Abstract BACKGROUND: To date, no study has compared the evolution of the foramen magnum area (FMA) and the posterior cranial fossa volume (PCFV) with the degree of cranial base synchondrosis ossification. OBJECTIVE: To illustrate these features in healthy children. METHODS: The FMA, the PCFV, and the ossification of 12 synchondroses according to the Madeline and Elster scale were retrospectively analyzed in 235 healthy children using millimeter slices on a computed tomography scan. RESULTS: The mean FMA of 6.49 cm2 in girls was significantly inferior to the FMA of 7.67 cm2 in boys (P &lt;.001). In both sexes, the growth evolved in a 2-phase process, with a phase of rapid growth from birth to 3.75 years old (yo) followed by a phase of stabilization. In girls, the first phase was shorter (ending at 2.6 yo) than in boys (ending at 4.33 yo) and proceeded at a higher rate. PCFV was smaller in girls (P &lt;.001) and displayed a biphasic pattern in the whole population, with a phase of rapid growth from birth to 3.58 yo followed by a phase of slow growth until 16 yo. In girls, the first phase was more active and shorter (ending at 2.67 yo) than in boys (ending at 4.5 yo). The posterior interoccipital synchondroses close first, followed by the anterior interoccipital and occipitomastoidal synchondroses, the lambdoid sutures simultaneously, then the petro-occipital and spheno-occipital synchondroses simultaneously. CONCLUSION: The data provide a chronology of synchondrosis closure. We showed that FMA and PCFV are constitutionally smaller in girls at birth (P ⩽.02) and suggest that a sex-related difference in the FMA is related to earlier closure of anterior interoccipital synchondroses in girls (P =.01).

scholarly journals Oligoclonal IgG bands in the cerebrospinal fluid of portuguese patients with multiple sclerosis: negative results indicate benign disease

2005 ◽  
Vol 63 (2b) ◽  
pp. 375-379 ◽  
Author(s):  
Maria José Sá ◽  
Lucinda Sequeira ◽  
Maria Edite Rio ◽  
Edward J. Thompson
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Benign Disease ◽  
Serum Samples ◽  
Negative Results ◽  
Significant Difference ◽  
Relapsing Remitting ◽  
The Mean ◽  
Oligoclonal Igg ◽  
Oligoclonal Igg Bands

We assessed the frequency of cerebrospinal fluid (CSF) restricted oligoclonal IgG bands (IgG-OCB) in Portuguese multiple sclerosis (MS) patients and its relationship with outcome. Paired CSF/serum samples of 406 patients with neurological disorders were submitted to isoelectric focusing with immunodetection of IgG. Ninety-two patients had definite MS; non-MS cases were assembled in groups inflammatory/infectious diseases (ID, n=141) and other/controls (OD, n=173). We found in the MS group: mean duration, 38.9 months; clinically isolated syndromes, 24%; relapsing/remitting course (RR), 65%; in RR patients the mean EDSS was 2.1 and the mean index of progression was 0.31. Positive patterns significantly predominated in MS (82.6%; ID, 40.4%; OD, 3.5%). The sensitivity and the specificity of positive IgG-OCB for MS diagnosis was 82.6% and 79.9%, respectively. The sole statistically significant difference in the MS group was the lower progression index observed in negative cases. We conclude that the frequency of positive IgG-OCB patterns in our MS patients fits most values reported in the literature, and that negative results indicate benign disease.

scholarly journals Sexual Dimorphism in Laryngeal Volumetric Measurements Using Magnetic Resonance Imaging

2019 ◽  
Vol 99 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Abdul-Latif Hamdan ◽  
Elie Khalifee ◽  
Georges Ziade ◽  
Sahar Semaan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Statistical Significance ◽  
Resonance Imaging ◽  
Men And Women ◽  
Mean Width ◽  
Significant Difference ◽  
The Mean ◽  
The Right ◽  
Volumetric Measurements

The objective of this study is to investigate the dimensional and volumetric measurements in the thyroarytenoid (TA) muscle in men and women using magnetic resonance imaging (MRI). The hypothesis is that there is a gender-related difference in these measurements. A retrospective chart review of 76 patients who underwent MRI of the neck at the American University of Beirut Medical Center was conducted. The dimension and volume of the right and left TA muscle were measured on axial and coronal planes short tau inversion recovery images. Male and female groups were compared with respect to demographic data and MRI findings using parametric and nonparametric tests. The mean length of the thyro-arytenoid muscle in males was larger than that in females on the right (males 2.44 [0.29] cm vs females 1.70 [0.22] cm) and on the left (males 2.50 [0.28] cm vs females 1.72 [0.24] cm) reaching statistical significance ( P < .001). The mean width of the thyro-arytenoid muscle in males was larger than that in females on the right (males 0.68 [0.13] cm vs females 0.59 [0.11] cm) and on the left (males 0.68 [0.12] cm vs females 0.57 [0.12] cm) reaching statistical significance ( P < .001). The mean height of the thyro-arytenoid muscle in males was larger than that in females on the right (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) and on the left (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) reaching statistical significance ( P < .01 on the right and P < .05 on the left). The volume of the thyroarytenoid muscle in males was larger than that in females on the right (males 0.86 [0.25] mL vs females 0.48 [0.15] mL) and on the left (males 0.89 [0.27] mL vs females 0.48 [0.17] mL) reaching statistical significance ( P < .001). The results of this investigation clearly indicate a significant difference in these measurements between men and women.

Impedance to Cerebrospinal Fluid Flow in the Cervical Spinal Canal is Dominated by Geometric Complexity

2011 ◽  
Author(s):  
Nicholas Shaffer ◽  
Francis Loth ◽  
Oliver Wieben ◽  
Brandon Rocque ◽  
Bermans Iskandar ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Canal ◽  
Unit Length ◽  
Graft Patency ◽  
Foramen Magnum ◽  
Cerebellar Tonsil ◽  
Type I ◽  
Cerebrospinal Fluid Flow ◽  
Cervical Spinal Canal ◽  
Wide Range

In a fluid system, longitudinal impedance (LI) is the impedance per unit length of a conduit. Its magnitude depends on conduit geometry and the mechanical properties of both the fluid and conduit. In the context of vein grafts, LI has been shown to correlate with vein graft size and graft patency at one year from surgery [1]. More generally, LI has been shown to be consistent over a wide range of physiological flows [2]. Due to its ability to characterize the effect of geometry on flow in a conduit, LI may be useful in examining differences between a healthy spinal canal and one affected by Type I Chiari malformation (CMI). CMI is a complex disorder of the craniospinal system classically characterized by herniation of the cerebellar tonsils of 3–5 mm past the foramen magnum [3], which has proven difficult to properly diagnose as the associated neurological symptoms may overlap with the symptomatology of other disorders. Current methods of quantifying CMI severity, such as cerebellar tonsil herniation depth, do not necessarily correlate with symptom severity. Likewise, studies that have sought to hydrodynamically analyze CMI by measuring cerebrospinal fluid (CSF) velocity have yielded mixed results. We hypothesized that the severity of obstruction to CSF flow in the CMI-affected cervical spinal canal can be quantified and compared by calculation of LI.

Anterior-Posterior (AP) Calcaneal Profile View: A Novel Radiographic Image to Assess Varus Malalignment

2020 ◽  
Vol 41 (10) ◽  
pp. 1249-1255
Author(s):  
John Y. Kwon ◽  
Bruno Moura ◽  
Tyler Gonzalez ◽  
Christopher P. Miller ◽  
Jorge Briceno
Keyword(s):  
Pairwise Comparison ◽  
Bonferroni Correction ◽  
Varus Malalignment ◽  
Profile View ◽  
Varus Angulation ◽  
Significant Difference ◽  
The Mean ◽  
Calcaneus Fractures ◽  
Axial View ◽  
Anterior Posterior

Background: Assessing and correcting malalignment is important when treating calcaneus fractures. The Harris axial view is commonly utilized to assess varus deformity but may be inherently inaccurate due to its tangential nature. The anterior-posterior (AP) calcaneal profile view is a novel radiographic view that is easily obtained with demonstrated increased accuracy for assessing calcaneal axial alignment. Methods: Five nonpaired ankle cadaveric specimens were used in this investigation. Oblique osteotomies were created in relation to the long axis, and varus deformities were produced by inserting solid radiolucent wedges into the osteotomies to create models of 10, 20, and 30 degrees of angulation of the calcaneal tuberosity. Specimens were imaged using both the Harris axial view and the AP calcaneal profile view. Results: For cadavers with 10 degrees of actual varus angulation, the mean Harris axial view angle and the AP calcaneal profile view angle were 10.9 ± 4.8 (range, 5.5-16.0) degrees and 13.0 ± 5.5 (range, 7.3-20.9) degrees, respectively. For cadavers with 20 degrees of actual varus angulation, the mean Harris view angle and the AP calcaneal profile view angle were 11.5 ± 2 (range, 8.2-13.6) degrees and 18.1 ± 4.8 (range, 11.7-23.5) degrees, respectively ( P = .005). On pairwise comparison with Bonferroni correction, there was a significant difference between the Harris axial view angle and both the AP calcaneal profile view angle ( P = .012) and actual angulation ( P = .011). For cadavers with 30 degrees of actual varus angulation, the mean Harris axial view angle and the AP calcaneal profile view angle were 18.3 ± 4.3 (range, 13.3-23.6) degrees and 28.3 ± 2.9 (range, 24.4-31.1) degrees, respectively ( P < .001). On pairwise comparison with Bonferroni correction, there was a significant difference between the Harris axial view angle and both the AP calcaneal profile view angle ( P = .001) and actual angulation ( P < .001). There was no significant difference between the AP calcaneal profile view angle and actual angulation ( P > .999). Conclusion: The AP calcaneal profile view is a novel radiographic view that is easily obtained with demonstrated increased accuracy for assessing calcaneal axial alignment. While both views demonstrated similar measurement error for lesser degrees of varus malalignment, the AP calcaneal profile view demonstrated more accurate measurement of increasing heel varus compared with the Harris view. Clinical Relevance: The AP calcaneal profile view could be used in addition to other radiographic views when treating displaced, intra-articular calcaneus fractures to help optimize correction of hindfoot alignment.

scholarly journals Quantitive Study on Some Aspect of Occipital Area in Domestic Cat (Felis catus)

2016 ◽  
pp. 18-21 ◽  
Author(s):  
M Uddin ◽  
ME Hossain ◽  
MS Islam ◽  
MB Hossain ◽  
KN Islam
Keyword(s):  
Foramen Magnum ◽  
Felis Catus ◽  
Occipital Bone ◽  
Domestic Cat ◽  
Clinical Anatomy ◽  
Significant Difference ◽  
The Mean ◽  
Level Of Significance ◽  
Occipital Condyles ◽  
Classification And Treatment

This study was planned to investigate some aspects of the morphometric characteristics of the occipital bone and foramen megnum in domestic cat (Felis catus). Twenty adult domestic cat including 10 males and 10 female cats were euthanized using diazepam (@ 20 mg/kg) and their skulls were macerated to give morphometric parameters. Student t-test with level of significance set at 5% (p < 0.05) was used to analyze the obtained values. The height of occipital triangle, width of occipital condyles, width of jugular process were significantly larger in male than female. The mean height and width of the foramen magnum were 1.32 ± 0.09 cm and 1.35 ± 0.08 cm, respectively, while the foramen index was below 100 at 90.72 ± 4.93. Parameters for the foramen magnum index showed significant difference between both sexes at p < 0.05. The foramen magnum showed shape variations and there were multiple hypoglossal foramina in over 80% of the cats. The morphometric values of the occipital bone and foramen magnum and clinical anatomy of the occipital region of the domestic cats provide an important baseline for further research in this field and could help in the better diagnosis, classification, and treatment of diseases related to this region and serve as a future reference defining an anatomic range.International Journal of Natural Sciences (2013), 3(1-4) 18-21

Paraplegia after a Routine Lumbar Laminectomy: Report of a Rare Complication and Successful Management

Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 638-640 ◽  
Author(s):  
Patrick L. Valls ◽  
Gill L. Naul ◽  
Steven L. Kanter
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Arachnoid Cyst ◽  
Spinal Canal ◽  
Rare Complication ◽  
Resonance Imaging ◽  
Thoracic Spinal

Abstract Arachnoid cysts of the spinal canal are relatively common lesions that may be either intra- or extradural. These cysts are usually asymptomatic but may produce symptoms by compressing the spinal cord or nerve roots. We report a case in which an intradural thoracic arachnoid cyst became symptomatic after a routine decompressive lumbar laminectomy for spinal stenosis. Myelography revealed no abnormality, although magnetic resonance imaging and computed tomography after myelography demonstrated a mass within the posterior aspect of the thoracic spinal canal associated with anterior displacement and compression of the spinal cord. A change in the flow dynamics of the cerebrospinal fluid probably allowed the development of spinal cord compression due to one of the following: expansion of the cyst, decreased cerebrospinal fluid buffer between the cord and the cyst, or epidural venous engorgement. A concomitant and more cephalad lesion such as an arachnoid cyst should be considered when myelopathic complications arise after lumbar surgery. Magnetic resonance imaging and computed tomography after myelography are useful to demonstrate the additional pathological processes.

scholarly journals MORPHOLOGICAL AND MORPHOMETRIC STUDY OF FORAMEN MAGNUM IN DRIED HUMAN SKULL BONES OF NORTH-WEST INDIAN REGION

2020 ◽  
Vol 8 (4.1) ◽  
pp. 7777-7781
Author(s):  
Suresh Sharma ◽  
◽  
Sakshi Mathur ◽  
Puneet Joshi ◽  
Upendra Kumar Gupta ◽  
...  
Keyword(s):  
West Indian ◽  
Craniovertebral Junction ◽  
Foramen Magnum ◽  
Morphometric Study ◽  
Transverse Diameter ◽  
North West ◽  
Important Landmark ◽  
Cranial Fossa ◽  
The Mean ◽  
Common Shape

Background: The Foramen Magnum is communication between vertebral canal and posterior cranial fossa and important landmark to key structures such as brain, spinal cord, vertebral arteries. Anatomical knowledge of the foramen magnum is significant for understanding the pathophysiology of various disorders of the craniovertebral junction as well as for planning surgical procedures. Materials and Methods: The study was conducted on 62 dry skulls of unknown gender obtained from the Department of Anatomy. The shape of foramen magnum was classified as oval, round, tetragonal, pentagonal, hexagonal and irregular in shape and measurements like anterio-posterior diameter and transverse diameter of foramen magnum were taken using the Digital Vernier sliding caliper. Results: In the present study most common shape was oval in 22 (35.48%) skulls, followed by Egg shape in 12 (19.35%) skulls and least common pentagonal shape in 1(1.61%) skulls. In our study the mean anteroposterior diameter was 34.17 mm. and mean transverse diameter was observed to be 28.86 mm. Conclusion: Results of our present study may help in neurosurgeons, orthopedicians, radiologist and anesthetist in North West indian population. KEY WORDS: foramen magnum, skull, transverse diameter, oval.

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