scholarly journals Microsurgical anatomy of the arterial basket of the conus medullaris

2015 ◽  
Vol 22 (6) ◽  
pp. 672-676 ◽  
Author(s):  
Nikolay L. Martirosyan ◽  
M. Yashar S. Kalani ◽  
G. Michael Lemole ◽  
Robert F. Spetzler ◽  
Mark C. Preul ◽  
...  
Keyword(s):  
Blood Supply ◽  
Vascular Malformations ◽  
Conus Medullaris ◽  
Microsurgical Anatomy ◽  
Arteriovenous Fistulas ◽  
Mean Diameter ◽  
The Mean ◽  
Posterior Spinal Arteries ◽  
The Right ◽  
Formalin Fixed

OBJECT The arterial basket of the conus medullaris (ABCM) consists of 1 or 2 arteries arising from the anterior spinal artery (ASA) and circumferentially connecting the ASA and the posterior spinal arteries (PSAs). The arterial basket can be involved in arteriovenous fistulas and arteriovenous malformations of the conus. In this article, the authors describe the microsurgical anatomy of the ABCM with emphasis on its morphometric parameters and important role in the intrinsic blood supply of the conus medullaris. METHODS The authors performed microsurgical dissections on 16 formalin-fixed human spinal cords harvested within 24 hours of death. The course, diameter, and branching angles of the arteries comprising the ABCM were then identified and measured. In addition, histological sections were obtained to identify perforating vessels arising from the ABCM. RESULTS The ASA tapers as it nears the conus medullaris (mean preconus diameter 0.7 ± 0.12 mm vs mean conus diameter 0.38 ± 0.08 mm). The ASA forms an anastomotic basket with the posterior spinal artery (PSA) via anastomotic branches. In most of the specimens (n= 13, 81.3%), bilateral arteries formed connections between the ASA and PSA. However, in the remaining specimens (n= 3, 18.7%), a unilateral right-sided anastomotic artery was identified. The mean diameter of the right ABCM branch was 0.49 ± 0.13 mm, and the mean diameter of the left branch was 0.53 ± 0.14 mm. The mean branching angles of the arteries forming the anastomotic basket were 95.9° ± 36.6° and 90° ± 34.3° for the right- and left-sided arteries, respectively. In cases of bilateral arterial anastomoses between the ASA and PSA, the mean distance between the origins of the arteries was 4.5 ± 3.3 mm. Histological analysis revealed numerous perforating vessels supplying tissue of the conus medullaris. CONCLUSIONS The ABCM is a critical anastomotic connection between the ASA and PSA, which play an important role in the intrinsic blood supply of the conus medullaris. The ABCM provides an important compensatory function in the blood supply of the spinal cord. Its involvement in conus medullaris vascular malformations makes it a critical anatomical structure.

Level I to III craniofacial approaches based on Barrow classification for treatment of skull base meningiomas: surgical technique, microsurgical anatomy, and case illustrations

2011 ◽  
Vol 30 (5) ◽  
pp. E5 ◽  
Author(s):  
Emel Avcı ◽  
Erinç Aktüre ◽  
Hakan Seçkin ◽  
Kutluay Uluç ◽  
Andrew M. Bauer ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Skull Base ◽  
Surgical Anatomy ◽  
Microsurgical Anatomy ◽  
Middle Point ◽  
The Mean ◽  
The Right ◽  
Skull Base Meningiomas ◽  
Supraorbital Foramen ◽  
Ethmoidal Foramen

Object Although craniofacial approaches to the midline skull base have been defined and surgical results have been published, clear descriptions of these complex approaches in a step-wise manner are lacking. The objective of this study is to demonstrate the surgical technique of craniofacial approaches based on Barrow classification (Levels I–III) and to study the microsurgical anatomy pertinent to these complex craniofacial approaches. Methods Ten adult cadaveric heads perfused with colored silicone and 24 dry human skulls were used to study the microsurgical anatomy and to demonstrate craniofacial approaches in a step-wise manner. In addition to cadaveric studies, case illustrations of anterior skull base meningiomas were presented to demonstrate the clinical application of the first 3 (Levels I–III) approaches. Results Cadaveric head dissection was performed in 10 heads using craniofacial approaches. Ethmoid and sphenoid sinuses, cribriform plate, orbit, planum sphenoidale, clivus, sellar, and parasellar regions were shown at Levels I, II, and III. In 24 human dry skulls (48 sides), a supraorbital notch (85.4%) was observed more frequently than the supraorbital foramen (14.6%). The mean distance between the supraorbital foramen notch to the midline was 21.9 mm on the right side and 21.8 mm on the left. By accepting the middle point of the nasofrontal suture as a landmark, the mean distances to the anterior ethmoidal foramen from the middle point of this suture were 32 mm on the right side and 34 mm on the left. The mean distance between the anterior and posterior ethmoidal foramina was 12.3 mm on both sides; the mean distance between the posterior ethmoidal foramen and distal opening of the optic canal was 7.1 mm on the right side and 7.3 mm on the left. Conclusions Barrow classification is a simple and stepwise system to better understand the surgical anatomy and refine the techniques in performing these complex craniofacial approaches. On the other hand, thorough anatomical knowledge of the midline skull base and variations of the neurovascular structures is crucial to perform successful craniofacial approaches.

scholarly journals Morphological study of the testis of adult Sudanese Chicken : gallus domesticus

2022 ◽  
Vol 7 (1) ◽  
Author(s):  
Al-Bajuri Salwa Ismail Abd al-Qadir
Keyword(s):  
Morphological Study ◽  
Gallus Domesticus ◽  
Cold Weather ◽  
Seminiferous Tubules ◽  
Left Testis ◽  
Adult Chicken ◽  
Mean Diameter ◽  
Hot Season ◽  
The Mean ◽  
The Right

Morphological study of the testis of adult Sudanese Chicken : gallus domesticus The adult chicken testes were two bean - shaped , large and soft , the left testis is usually higher in position and larger in size than the right one . The testis is active during cold weather with the mean diameter of the seminiferous tubules being 126^m in the chicken . it is less active during the hot season with the mean diameter of the seminiferous tubules being 135^m in the chicken. The non - breeding season seemed to be characterized by a decline in the spermatogenic activity only and not by complete spermatogenesis

scholarly journals Prevalence of the Anterior Occipital Sulcus in the Human Brain: Anatomical Study

2016 ◽  
Vol 23 (1) ◽  
pp. 19-22
Author(s):  
Bassam MJ Addas
Keyword(s):  
Human Brain ◽  
Temporal Lobe ◽  
External Surface ◽  
Anatomical Study ◽  
Occipital Lobe ◽  
The Mean ◽  
The Right ◽  
Human Brains ◽  
Formalin Fixed

The objective of this article is to investigate the prevalence of the anterior occipital sulcus in the human brain. The external surface of 25 consecutive formalin fixed brains (50 hemispheres) were examined for the presence of the anterior occipital sulcus. The anterior occipital sulcus was identified in 11 (22%) hemispheres, seven on the right side and four on the left side. The sulcus length ranged from 1-5 cm with a mean length of 2.89 cm. The mean distance from the occipital lobe tip to the anterior occipital sulcus was 4.75 cm on the right side and 5 cm on the left side. The anterior occipital sulcus can be infrequently encountered in human brains (22%); when present it represents the posterior limit of the temporal lobe and the anterior limit of the occipital lobe.

scholarly journals 3 Years Expeimental Study on Abdominal Aortic Aneurysm Patients Who were Treated with Endovascular Aneurysm Repair at Dr. Mohammad Hoesin Hospital Palembang During 1st of January 2018 – 31st of December 2020

2021 ◽  
Vol 4 (2) ◽  
pp. 286-304
Author(s):  
Muhammad Febriandi Djunaidi ◽  
Kemas Muhammad Dahlan ◽  
Fahmi Jaka Yusuf
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Femoral Artery ◽  
Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic ◽  
Mean Diameter ◽  
History Of ◽  
The Mean ◽  
The Right

Abdominal aortic aneurysm (AAA) is a focal dilatation of the aortic segment with an increase of 1.5 times the normal value or ≥3 cm. The risk increases in old age and requires alternative surgery such as EVAR. EVAR is more useful in AAA therapy than surgery with wide incisions. This research was descriptive in RSMH Palembang for 5 years in 1st of January 2018 - 31st of December 2020 with variables of patient clinical characteristics and patient CTA results. The results showed that AAA was more common in men, aged 60-69 years with high school education, risk factors such as a history of CHF, hypertension, CAD, and smoking habits. Angiographic CT result showed proximal diameter > 2 cm, PAU, calcification, iliac aneurysm, and lowest renal artery on the left side. All AAA patients had inferior limb thrombus and angulation > 600. The average of aneurysm is 5.8 cm in diameter and 9.23 cm in length. The mean diameter of the right iliac artery differs from the mean diameter of the left iliac artery. The diameter of the right femoral artery also differs from the diameter of the left femoral artery. AAA patients mostly had no history of CKD, COPD, and DM. The patients were hospitalized for an average of 7 days, especially in the ICU for 2 days.

Cervical spine dural arteriovenous fistula presenting with congestive myelopathy of the conus

2009 ◽  
Vol 11 (4) ◽  
pp. 427-431 ◽  
Author(s):  
Sasikhan Geibprasert ◽  
Sirintara Pongpech ◽  
Pakorn Jiarakongmun ◽  
Timo Krings
Keyword(s):  
Cervical Spine ◽  
Clinical Symptoms ◽  
Vascular Malformations ◽  
Transarterial Embolization ◽  
Conus Medullaris ◽  
Imaging Findings ◽  
Arteriovenous Fistulas ◽  
Spinal Vascular Malformations ◽  
Arteriovenous Shunts ◽  
Spinal Dural Arteriovenous Fistulas

Spinal dural arteriovenous fistulas (DAVFs) are the spinal vascular malformations that are encountered most often, and they are usually encountered in the lower thoracic region. Cervical spine DAVFs are exceedingly rare and may be difficult to differentiate from radicular arteriovenous malformations, epidural arteriovenous shunts, or perimedullary AVFs. Typical angiographic findings in spinal DAVFs include a slow-flow shunt with converging feeding vessels from radiculomeningeal arteries draining via a radicular vein centripetally into perimedullary veins. The MR imaging findings such as spinal cord edema and perimedullary dilated vessels may be used to direct the spinal angiography that is needed to localize and classify the shunt. When the shunt is distant from the pathological imaging findings, the diagnosis may be difficult to establish, especially when the shunt is present at an atypical location such as the cervical spine. The authors present the case of a 51-year-old man presenting with lower thoracic and conus medullaris congestive edema due to a cervical spine DAVF that was located at the C-5 level. Transarterial embolization with N-butyl cyanoacrylate closed the proximal vein and completely obliterated the fistula. Clinical and imaging follow-up confirmed occlusion of the fistula, with improvement in clinical symptoms.

scholarly journals Cauda equina arteriovenous fistula supplied by proximal radicular artery and concomitant sacral dural arteriovenous fistula: A case report and literature review

2021 ◽  
Vol 12 ◽  
pp. 405
Author(s):  
Prasert Iampreechakul ◽  
Punjama Lertbutsayanukul ◽  
Somkiet Siriwimonmas
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
Vascular Malformations ◽  
Cauda Equina ◽  
Unknown Origin ◽  
Vascular Lesion ◽  
Conus Medullaris ◽  
Venous Hypertension ◽  
Arteriovenous Fistulas ◽  
Spinal Vascular Malformations

Background: Cauda equina arteriovenous fistulas (AVFs) fed by the proximal radicular artery are exceedingly rare. Spinal dural arteriovenous fistulas (DAVFs) in the sacral region are rare and usually misdiagnosed. We report a case of a cauda equina AVF with concomitant sacral DAVF. We also review the coexistence of multiple types of spinal vascular malformations in a single patient. Case Description: A 54-year-old man presented with progressive weakness of the lower extremities for 1 month. Magnetic resonance imaging (MRI) of the lumbosacral and thoracic spine showed spinal cord congestion, extending from the conus medullaris to the level of T7, and abnormal tortuous and dilated flow void, running from the level of L5 to T12 along anterior surface of the spinal cord. Spinal angiography demonstrated the fistula at the level of L2 below the conus medullaris. Based on intraoperative findings, the cauda equina AVF supplied by the proximal radicular artery with cranial drainage through the enlarged radicular vein was confirmed and successfully obliterated. Another enlarged arterialized radicular vein running parallel to another cauda equina nerve root is observed with unknown origin. After the operation, the patient showed mild improvement of his symptoms. Follow-up MRI and contrast-enhanced MR angiography revealed an another sacral DAVF vascularized by the lateral sacral artery. Conclusion: The coexistence of different spinal vascular malformations in a same patient is extremely rare. Most authors of several studies hypothesized that venous hypertension and thrombosis due to the presence or treatment of the first spinal vascular lesion may produce a second DAVF.

Stent Placement for Idiopathic Obstruction of the Inferior Vena Cava

1996 ◽  
Vol 4 (3) ◽  
pp. 142-145
Author(s):  
Rajiv Agarwal ◽  
Upendra Kaul ◽  
Pradeep Jain ◽  
Sanjeev Sharma ◽  
Sanjiv Sharma ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Balloon Angioplasty ◽  
Inferior Vena ◽  
Vena Cava ◽  
Total Occlusion ◽  
Inferior Vena Cava Obstruction ◽  
Mean Diameter ◽  
Chiari Syndrome ◽  
The Mean ◽  
The Right

Ten patients (mean age 36.6 ± 8 years; 5 male) with idiopathic inferior vena cava obstruction underwent balloon angioplasty, followed by placement of a self-expanding stent. Six had total occlusion, 5 had restenosis (including 2 with total occlusion), and I had a suboptimal result after initial dilatation. The mean diameter of the inferior vena cava increased from 1.5 ± 2.1 mm to 14.4 ± 2.7 mm, and the pressure gradient between the vena cava and the right atrium decreased from 15.2 ± 5.0 mm Hg to 1.1 ± 1.5 mm Hg. Follow-up venography after 74 ± 35 days in 6 patients, revealed ho restenosis, with further enlargement of the mean diameter by 5.2 ± 3.1 mm (44 ± 35%) and abolition of pressure gradients. One patient died 6 months after the procedure from acute Budd-Chiari syndrome. Autopsy revealed a widely patent stent with hepatic vein thrombus. Stent implantation is useful in the management of inferior vena cava obstruction with prior restenosis, total occlusion, or suboptimal results of balloon angioplasty.

Microsurgical Anatomy of the Precuneal Artery: Does It Really Exist? Clarifying an Ambiguous Vessel Under the Microscope

2015 ◽  
Vol 12 (1) ◽  
pp. 68-76 ◽  
Author(s):  
Ioannis N Mavridis ◽  
Theodosis Kalamatianos ◽  
Christos Koutsarnakis ◽  
George Stranjalis
Keyword(s):  
Significant Variation ◽  
Posterior Cerebral Artery ◽  
Average Distance ◽  
Microsurgical Anatomy ◽  
Operating Microscope ◽  
Elderly Individuals ◽  
The Right ◽  
Artery Branch ◽  
Formalin Fixed ◽  
Complex Origin

Abstract BACKGROUND The ambiguous term precuneal artery (PA) has several synonyms and anatomic definitions. OBJECTIVE To examine the arteries of the precuneus and describe the PA and its branching pattern. We defined the PA as the principal arterial supplier of the precuneus. METHODS Twenty formalin-fixed, colored latex–injected cadaveric heads were studied with the aid of an operating microscope and microsurgical instrumentation. After removal of the cerebrum from the cranial vault, we examined this vessel's anatomy. Anatomic features of the PA were investigated and assessed in relation to demographic and anthropometric variables. RESULTS The PA was always a pericallosal artery branch and, more specifically, the superior internal parietal artery (SIPA) in 86.84%, the inferior internal parietal artery in 2.63%, and their common stem in 10.53% of specimens. Anastomosing interhemispheric branches between the PAs were present in 20% of cases. Compared with the right PA, the left anastomosed nearly 3 times more often with the ipsilateral posterior cerebral artery. The average distance of the PA's origin from the posterior limit of the splenium was shown to be 9.4 mm longer in elderly individuals compared with younger ones. CONCLUSION The term PA complex (rather than PA) can better describe the principal arterial supplier of the precuneus, and the SIPA, inferior internal parietal artery, and their common stem were shown as the 3 contributing arteries, with the SIPA predominating. The average distance of the PA complex origin from the splenium's posterior limit shows significant variation with respect to age.

scholarly journals A cadaveric study of the testicular artery and its clinical significance

2016 ◽  
Vol 15 (4) ◽  
pp. 280-286 ◽  
Author(s):  
Sushma R. Kotian ◽  
◽  
Arvind Kumar Pandey ◽  
Supriya Padmashali ◽  
Judith Jaison ◽  
...  
Keyword(s):  
Mesenteric Arteries ◽  
Testicular Atrophy ◽  
Adult Males ◽  
Operative Techniques ◽  
Testicular Artery ◽  
Old Adult ◽  
The Mean ◽  
The Right ◽  
Insight Into ◽  
Formalin Fixed

Abstract Background Knowledge of testicular artery variations is vital to ensure that they are not neglected during a variety of different operative techniques, since damage can cause testicular atrophy. Objectives The present study was therefore intended to identify variants in the origin and course of the testicular arteries. An attempt was made to classify the arteries based on their various origins. Methods This study examined 42 formalin-fixed cadavers of 40 to 70-year-old adult males. Variant origins of the testicular artery were identified and classified. Variations in the origin and course of the artery were colored, photographed, and documented. The distances between the origins of the testicular arteries and the mid-points of the origins of the renal arteries were measured. Results Testicular arteries were classified into four categories on the basis of origin. This variability was defined in relation to the renal and inferior mesenteric arteries. The mean distance between the origin of the testicular artery and the mid-point of the origin of the renal artery were 3.08 and 3.47 cm, on the right and left sides respectively. Variations were almost exclusively found on the left side. The variations observed included multiple arterial twigs forming the testicular artery, suprarenal arteries arising from the testicular artery, and testicular artery duplication. Conclusion This study provides an insight into variations in the testicular artery and proposes a classification which could help surgeons during a variety of procedures on the male abdomen and pelvis.

scholarly journals Results of the surgical treatment of perimedullary arteriovenous fistulas with special reference to embolization

1998 ◽  
Vol 5 (4) ◽  
pp. E11
Author(s):  
Kazutoshi Hida ◽  
Yoshinobu Iwasaki ◽  
Katsuya Goto ◽  
Kazuo Miyasaka ◽  
Hiroshi Abe
Keyword(s):  
Surgical Treatment ◽  
Neurological Status ◽  
Conus Medullaris ◽  
Anterior Spinal Artery ◽  
Preoperative Embolization ◽  
Complete Disappearance ◽  
Arteriovenous Fistulas ◽  
Arteriovenous Shunts ◽  
Posterior Spinal Arteries ◽  
Av Shunt

This retrospective study was performed to evaluate the results of surgical treatment and the use of preoperative embolization in managing perimedullary arteriovenous fistulas (AVFs). The authors studied 20 consecutive patients with perimedullary AVFs who underwent surgical treatment. Arteriovenous shunts were at the level of the cervical spine in five patients, the thoracic spine in 12, and the conus medullaris in three patients. Of the 20 AVFs, three were fed by the anterior spinal artery only, three by the posterior spinal artery, and 14 by both the anterior and posterior spinal arteries. Nine patients had varices that compressed the spinal cord. Eleven patients underwent surgery alone, and 9 patients underwent surgery combined with adjuvant preoperative embolization. Preoperative embolization remarkably reduced the blood flow through AVFs and facilitated subsequent surgical procedures. Postoperative angiography revealed complete disappearance of the AVF in 16 patients. However, small fistulas persisted in the other four patients whose large lesions were fed by the anterior spinal artery. Neurological status was improved in 11 patients, unchanged in eight, and worse in one patient postsurgery. Effective interruption of a spinal AV shunt was obtained by surgery in all cases, even when the anterior spinal artery was involved. For large and high-flow AVFs, embolization proved to be a useful adjunct to surgery.

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