scholarly journals Inion Not a Reliable Landmark of the Torcula in Posterior Fossa Craniotomies

2020 ◽  
Vol 17 (3) ◽  
pp. 103-105
Author(s):  
Elisha Harry Otieno ◽  
Philip Mwachaka ◽  
Paul Odula ◽  
Isaac Cheruiyot ◽  
Jeremiah Munguti
Keyword(s):  
Posterior Fossa ◽  
Posterior Cranial Fossa ◽  
Burr Hole ◽  
Surgical Approaches ◽  
Iatrogenic Injuries ◽  
Cranial Fossa

Background: Sub-occipital craniotomies are used in surgical approaches into the posterior cranial fossa. The inion is used as an extracranial landmark of the torcula in burr hole placement. However, inadvertent damage to the torcula and the related sinuses due to variant intracranial location of the torcula has been reported. This study aimed at determining the position of the torcula in relation to the inion. Method: 40 adult open skulls were obtained and the positional relationship between the inion and the torcula assessed. Results: The torcula was at the same level with the inion in half of the cases (50%), below it in 12 cases (30%), and above in 8 cases (20%). The position above the inion ranged from 0.38 to 2.40 cm and below it from 0.75 to 2.45 cm. Conclusion: The torcula lies either at the level of the inion in only half of the cases. The surgeon should augment this physical landmark with radiographs to avoid iatrogenic injuries. Keywords: Inion, Posterior fossa, Craniotomies

scholarly journals PHACE Syndrome: Persistent Fetal Vascular Anomalies

2005 ◽  
Vol 11 (4) ◽  
pp. 355-361 ◽  
Author(s):  
V. Prochazka ◽  
T. Hrbac ◽  
J. Chmelova ◽  
D. Skoloudik ◽  
M. Prochazka
Keyword(s):  
Posterior Fossa ◽  
Posterior Cranial Fossa ◽  
Vascular Anomalies ◽  
Cardiac Defects ◽  
Phace Syndrome ◽  
Cranial Fossa ◽  
Arterial Anomalies

PHACE(S) syndrome is an acronym for neurocutaneous disease encompassing the expression of (P) posterior cranial fossa malformations, (H) facial haemangiomas, (A) arterial anomalies, (C) aortic coarctaion and other cardiac defects, (E) eye abnormalities and (S) for sternal malformation or stenotic arterial diseases. We report on a case of PHACE syndrome complete expression with persistent fetal vascular anomalies unusually in a 55-year-old women with large bilateral facial and neck haemangioma and posterior fossa circulation insufficiency.

Patterns for Differentiation of Posterior Fossa Neoplasms as Detected by Brain Scans

1970 ◽  
Vol 09 (04) ◽  
pp. 303-316
Author(s):  
Frank DeLand ◽  
A. EveretteJames ◽  
Henry Wagner
Keyword(s):  
Skull Base ◽  
Posterior Fossa ◽  
Cerebellopontine Angle ◽  
Lateral View ◽  
Posterior Cranial Fossa ◽  
Anatomical Location ◽  
Posterior View ◽  
Brain Scans ◽  
Histological Characteristics ◽  
Cranial Fossa

SummaryThe histological characteristics of neoplasms that occur in the posterior cranial fossa can often be predicted by a knowledge of the patient’s age and the specific anatomical location of the tumor. Dividing the posterior fossa into midline, cerebellar fossa and cerebellopontine angle provides a scheme to characterize abnormal accumulations of radioactivity according to their anatomical locations. Midline lesions arise from bases activity on the lateral view and are in the midline on the posterior view. Lesions of the cerebellar fossa may be adjacent to but do not appear to arise from the basal structures and are not in the midline. Cerebellopontine angle tumors are adjacent to and appear to arise from the normal radioactivity at the skull base but lie lateral to the midline. The expected distribution of histological types of neoplasms in each area according to age are discussed.

Volumetric analysis of the posterior cranial fossa in a family with four generations of the Chiari malformation Type I

2008 ◽  
Vol 1 (1) ◽  
pp. 21-24 ◽  
Author(s):  
R. Shane Tubbs ◽  
Mark Hill ◽  
Marios Loukas ◽  
Mohammadali M. Shoja ◽  
W. Jerry Oakes
Keyword(s):  
Posterior Fossa ◽  
Chiari Malformation ◽  
Familial Aggregation ◽  
Volumetric Analysis ◽  
Posterior Cranial Fossa ◽  
Preoperative Imaging ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Hindbrain Herniation ◽  
Cranial Fossa

Object Many authors have concluded that the Chiari malformation Type I (CM-I) is due to a smaller than normal posterior cranial fossa. In order to establish this smaller geometry as the cause of hindbrain herniation in a family, the authors of this paper performed volumetric analysis in a family found to have this malformation documented in 4 generations. Methods Members from this family found to have a CM-I by imaging underwent volumetric analysis of their posterior cranial fossa using the Cavalieri method. Results No member of this family found to have CM-I on preoperative imaging had a posterior fossa that was significantly smaller than that of age-matched controls. Conclusions The results of this study demonstrate that not all patients with a CM-I will have a reduced posterior cranial fossa volume. Although the mechanism for the development of hindbrain herniation in this cohort is unknown, this manifestation can be seen in multiple generations of a familial aggregation with normal posterior fossa capacity.

Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa

1997 ◽  
Vol 86 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Misao Nishikawa ◽  
Hiroaki Sakamoto ◽  
Akira Hakuba ◽  
Naruhiko Nakanishi ◽  
Yuichi Inoue
Keyword(s):  
Posterior Fossa ◽  
Medulla Oblongata ◽  
Chiari Malformation ◽  
Volume Ratio ◽  
Basilar Invagination ◽  
Posterior Cranial Fossa ◽  
Control Group ◽  
Adult Type ◽  
Content Type ◽  
Cranial Fossa

✓ To investigate overcrowding in the posterior cranial fossa as the pathogenesis of adult-type Chiari malformation, the authors studied the morphology of the brainstem and cerebellum within the posterior cranial fossa (neural structures consisting of the midbrain, pons, cerebellum, and medulla oblongata) as well as the base of the skull while taking into consideration their embryological development. Thirty patients with Chiari malformation and 50 normal control subjects were prospectively studied using neuroimaging. To estimate overcrowding, the authors used a “volume ratio” in which volume of the posterior fossa brain (consisting of the midbrain, pons, cerebellum, and medulla oblongata within the posterior cranial fossa) was placed in a ratio with the volume of the posterior fossa cranium encircled by bony and tentorial structures. Compared to the control group, in the Chiari group there was a significantly larger volume ratio, the two occipital enchondral parts (the exocciput and supraocciput) were significantly smaller, and the tentorium was pronouncedly steeper. There was no significant difference in the posterior fossa brain volume or in the axial lengths of the hindbrain (the brainstem and cerebellum). In six patients with basilar invagination the medulla oblongata was herniated, all three occipital enchondral parts (the basiocciput, exocciput, and supraocciput) were significantly smaller than in the control group, and the volume ratio was significantly larger than that in the Chiari group without basilar invagination. These results suggest that in adult-type Chiari malformation an underdeveloped occipital bone, possibly due to underdevelopment of the occipital somite originating from the paraxial mesoderm, induces overcrowding in the posterior cranial fossa, which contains the normally developed hindbrain. Basilar invagination is associated with a more severe downward herniation of the hindbrain due to the more severely underdeveloped occipital enchondrium, which further exacerbates overcrowding of the posterior cranial fossa.

scholarly journals Posterior vault “free-floating” bone flap: indications, technique, advantages, and drawbacks

2021 ◽  
Author(s):  
Gianpiero Tamburrini ◽  
Martina Offi ◽  
Luca Massimi ◽  
Paolo Frassanito ◽  
Federico Bianchi
Keyword(s):  
Posterior Fossa ◽  
Surgical Management ◽  
Distraction Osteogenesis ◽  
Honeycomb Structure ◽  
Posterior Cranial Fossa ◽  
Bone Flap ◽  
Intracranial Volume ◽  
Review Of The Literature ◽  
Management Options ◽  
Cranial Fossa

Abstract Background The enlargement of the posterior cranial fossa volume is considered one of the main steps of the surgical management of children with multiple sutures craniosynostosis. Different management options have been proposed including fixed expansive craniotomy, free bone flap craniotomy, and distraction osteogenesis. Objectives To review indications to “free bone flap” craniotomy for the posterior fossa expansion, detailing advantages, disadvantages, and complications related to the technique. Results and conclusions A review of the literature shows that “free bone flap” posterior expansion cranioplasty still has a role, particularly in infants with thin and “honeycomb” structure of the bone, allowing to gain adequate intracranial volume increases and to postpone to a more adequate time surgery aimed at anterior cranial fossa expansion.

scholarly journals Posterior Cranial Fossa Meningioma Causing Tonsillar Herniation and Giant Cervicothoracic Syringomyelia, Case Report and Review of Literature

2021 ◽  
Author(s):  
Estelle Anne How Hong ◽  
Shalid Ahmed ◽  
Srihari Deepak ◽  
Gueorgui Kounin
Keyword(s):  
Spinal Cord ◽  
Posterior Fossa ◽  
Foramen Magnum ◽  
Posterior Cranial Fossa ◽  
Tonsillar Herniation ◽  
Ataxic Gait ◽  
Complete Excision ◽  
Arnold Chiari Malformation ◽  
Posterior Cranial Fossa Tumours ◽  
Cranial Fossa

Abstract Background Syringomyelia is a fluid-filled cyst within the spinal cord and usually associated with Arnold-Chiari malformation. Posterior cranial fossa tumours are a rare cause of tonsillar herniation and secondary syringomyelia. Case Presentation: We report a rare case of a 56-year-old female with posterior cranial meningioma and secondary syringomyelia, admitted with headache, nausea, vomiting, and ataxic gait. MRI demonstrated a large posterior fossa lesion causing early ventriculomegaly and syrinx within the upper spinal cord extending from the hindbrain inferiorly to the level of T8. She underwent a posterior fossa craniectomy with left C1 hemilaminectomy and complete excision of the tumour. In 6 months following her procedure, MRI scan showed a significant reduction in the calibre of the syringomyelia throughout its length and there was a significant improvement in symptoms. Literature review: A PubMed literature search was carried out with keywords: “syringomyelia”, “posterior fossa” and “tumour”. 120 articles were reviewed. The inclusion criteria for this study was posterior fossa meningioma causing syrinx formation. A total of 9 isolated similar cases were identified. Discussion Tonsillar herniation and syringomyelia secondary to posterior cranial fossa meningioma are rare. The alteration in the dynamic flow of CSF is likely to be the cause for the formation and enlargement of the syrinx. Conclusion Although the pathophysiology of syrinx formation is still poorly understood, the alteration of CSF dynamic has been implicated, but a common unifying cause appears to be increased transcranial difference in intracranial pressure across the foramen magnum causing tonsillar herniation, irrespective of location in the posterior fossa. Posterior fossa craniotomy and excision of the lesion is the mainstay treatment.

scholarly journals Costello syndrome: Analysis of the posterior cranial fossa in children with posterior fossa crowding

2015 ◽  
Vol 28 (3) ◽  
pp. 254-258 ◽  
Author(s):  
Rosalinda Calandrelli ◽  
Gabriella D’Apolito ◽  
Marco Panfili ◽  
Giuseppe Zampino ◽  
Tommaso Tartaglione ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Posterior Cranial Fossa ◽  
Costello Syndrome ◽  
Cranial Fossa ◽  
Syndrome Analysis
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