scholarly journals Anatomic variation of the flexor digiti minimi brevis muscle: a morphological and functional study: case report

2015 ◽  
Vol 32 (04) ◽  
pp. 269-272
Author(s):  
V. Moraes ◽  
S. Siqueira ◽  
F. Rodrigues ◽  
E. Queiroz ◽  
I. Pinto ◽  
...  
Keyword(s):  
Medical Literature ◽  
Clinical Symptoms ◽  
Morphological Changes ◽  
Anatomic Variation ◽  
Anatomical Variation ◽  
Muscle Size ◽  
Functional Study ◽  
Vascular Compression ◽  
Ulnar Nerve Compression ◽  
Anomalous Muscle

Abstract Introduction: A great amount of accessory and supernumerary muscles, or even their absence, has already been described in medical literature, related to Anatomy, Surgery and Radiology. In the majority of cases, muscles with any morphological changes, in their origins, insertions, number of muscle bellies and anomalous vascular or nervous patterns, are asymptomatic. However, approximately 3% of compression neuropathy cases are results of an anomalous muscle. Material and methods: During a routine dissection, an anatomical variation was found on the left hypothenar region of an afrodescendant adult's corpse, which led the authors to further investigate its incidence and the clinical significance of this variation, basing up of articles published in refereed journals and renowned books on this subject. Results: Many authors have already identified numerous muscle variations in the hypothenar region, whether in dissection labs or in private clinics. Since some muscular variations may cause numerous clinical symptoms, it's important to have a detailed anatomical knowledge of the correspondent region. There are cases of ulnar nerve compression caused by an anomalous flexor digiti minimi brevis described in the medical literature. The majority of authors explained the nervous and vascular compression from some factors as injury, small repetitive traumas, genetically predetermined muscle size and muscular hypertrophy. Conclusion: The importance of differential diagnosis to any affections of the hypothenar region lies on the anatomical and surgical knowledge of the structures quoted in this study, the statistics related to the prevalence of these anatomical variations and the relevance of these in the present case.

scholarly journals A Possible Accessory Muscle of the Serratus Posterior Superior Muscle

Reports ◽  
2021 ◽  
Vol 4 (1) ◽  
pp. 2
Author(s):  
Kerrie Lashley ◽  
Guinevere Granite
Keyword(s):  
Medical Literature ◽  
Anatomical Variation ◽  
Transverse Process ◽  
Neck Muscle ◽  
Normal Range ◽  
Accessory Muscle ◽  
Anomalous Muscle ◽  
Anatomical Finding ◽  
Serratus Posterior Superior

Anatomical variation is defined as the normal range of possibilities in the topography and morphology of body structures. In contrast, an anomaly is any structural or functional anatomical finding beyond the normal range of possibilities. This case study describes a muscular anomaly found in a 73-year-old preserved Caucasian male. We observed a left-sided anomalous muscle originating from the transverse process of the C1 (Atlas) vertebra and inserting onto the proximal attachment of the serratus posterior superior (SPS) muscle at the C7 level. We suggest that this anomaly is a result of early embryological development and hypothesize that the atypical neck muscle may reinforce the action of the SPS. This finding is rare and no reference of it can be found in the literature. Reporting anatomical anomalies is important for the medical literature and education.

Unusual Presentations of Ulnar Nerve Paresthesia: Mycotic Aneurysm and Leprosy

1996 ◽  
Vol 4 (4) ◽  
pp. 1-7
Author(s):  
Susan D Moffatt ◽  
Winston S Parkhill
Keyword(s):  
Plastic Surgery ◽  
Ulnar Nerve ◽  
Mycotic Aneurysm ◽  
Clinical Symptoms ◽  
Nerve Compression ◽  
Rare Occurrence ◽  
Common Occurrence ◽  
Canadian Hospital ◽  
Ulnar Nerve Compression

Ulnar nerve compression causing clinical symptoms is a common occurrence. There are numerous conditions that can cause compression. Recently two very interesting and unusual etiologies were seen at the Plastic Surgery service. Leprosy causing ulnar nerve compression is a rare occurrence in a Canadian hospital, and so is a case of palmar mycotic aneurysm in the postantibiotic era.

Comparison of Clinical Symptoms and Magnetic Resonance Angiographic (MRA) Results in Patients with Trigeminal Neuralgia and Persistent Idiopathic Facial Pain. Medium-Term Outcome after Microvascular Decompression of Cases with Positive MRA Findings

Cephalalgia ◽  
2006 ◽  
Vol 26 (3) ◽  
pp. 266-276 ◽  
Author(s):  
A Kuncz ◽  
E Vörös ◽  
P Barzó ◽  
J Tajti ◽  
P Milassin ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Facial Pain ◽  
Clinical Symptoms ◽  
Vascular Compression ◽  
Term Outcome ◽  
Persistent Idiopathic Facial Pain ◽  
Venous Compression ◽  
Imaging Results

To evaluate whether NC could be demonstrated preoperatively, high-resolution magnetic resonance angiography (MRA) was performed in 287 consecutive patients with TN and persistent idiopathic facial pain (PIFP) on a 0.5-T and a 1-T MR unit. Depending on the clinical symptoms, the TN cases were divided into typical TN and trigeminal neuralgia with non-neuralgic interparoxysmal pain (TNWIP) groups. Microvascular decompression (MVD) was performed in 103 of the MRA-positive cases. The patients were followed up postoperatively for from 1 to 10 years. The clinical symptoms were compared with the imaging results. The value of MRA was assessed on the basis of the clinical symptoms and surgical findings. The outcome of MVD was graded as excellent, good or poor. The clinical symptoms were compared with the type of vascular compression and the outcome of MVD. The MRA image was positive in 161 (56%) of the 287 cases. There were significant differences between the clinical groups: 66.5% of the typical TN group, 47.5% of the TNWIP group and 3.4% of the PIFP group were positive. The quality of the MR unit significantly determined the ratio of positive/negative MRA results. The surgical findings corresponded with the MRA images. Six patients from the MRA-negative group were operated on for selective rhizotomy and no NC was found. Venous compression of the trigeminal nerve was observed in a significantly higher proportion in the background of TNWIP than in that of typical TN on MRA imaging (24.1% and 0.8%, respectively) and also during MVD (31.2% and 1.2%, respectively). Four years following the MVD, 69% of the patients gave an excellent, 23% a good and 8% a poor result. The rate of some kind of recurrence of pain was 20% in the typical TN and 44% in TNWIP group. The rate of recurrence was 57% when pure venous compression was present. The only patient who was operated on from the PIFP group did not react to the MVD. The clinical symptoms and preoperative MRA performed by at least a 1-T MR unit furnish considerable information, which can play a role in the planning of the treatment of TN.

scholarly journals Distal ulnar nerve compression due to an anomalous muscle and a ganglion.

1987 ◽  
Vol 35 (3) ◽  
pp. 965-967
Author(s):  
Sinji Izumi ◽  
Issei Higashi ◽  
Hidetoshi Kouda ◽  
Toshio Kitagawa ◽  
Makoto Kai
Keyword(s):  
Ulnar Nerve ◽  
Nerve Compression ◽  
Ulnar Nerve Compression ◽  
Anomalous Muscle

Analysis of therapeutic choices for slit ventricle syndrome after cyst-peritoneal shunting for temporal arachnoid cysts in children

2010 ◽  
Vol 6 (5) ◽  
pp. 474-480 ◽  
Author(s):  
Tie Fang ◽  
Jinshan Xu ◽  
Shejun Wang ◽  
Zhenyu Ma ◽  
Jian Xing
Keyword(s):  
Temporal Lobe ◽  
Clinical Symptoms ◽  
Morphological Changes ◽  
Arachnoid Cysts ◽  
Slit Ventricle Syndrome ◽  
Delayed Treatment ◽  
Radiological Data ◽  
Programmable Valve ◽  
Slit Ventricle ◽  
Radiological Studies

Object The goal in this study was to investigate early diagnostic evidence, optimal therapeutic strategies, and prophylactic methods for slit ventricle syndrome (SVS) in patients with temporal lobe arachnoid cysts who received cyst-peritoneal (CP) shunts. Methods Six cases of SVS in patients with temporal lobe arachnoid cysts who received CP shunts were treated by the senior authors in 2 institutions between January 2005 and January 2009. The radiological data, treatment process, and therapeutic results were reviewed retrospectively. Results There were 4 boys and 2 girls, whose mean age at presentation was 4 years and 1 month. The main clinical symptoms were severe headache, nausea, vomiting, and decreasing eyesight. Radiological studies showed normal or slightly smaller than normal ventricles, and arachnoid cysts that had shrunk dramatically. The most effective treatment for SVS was to replace the original shunts with devices that had a programmable valve, or if this was unsuccessful, to replace the original shunts with ventriculoperitoneal (VP) shunts. All symptoms in these patients disappeared, and the mean follow-up duration was 24 months. Conclusions The SVS presents more often in patients with hydrocephalus who undergo VP shunting. However, it is also a serious complication in patients with arachnoid cysts who receive a CP shunt. The SVS is not a single condition; rather, different pathophysiological conditions can underlie this complicated syndrome. Because there are no striking morphological changes on radiological studies of the SVS in the patients with CP shunts, it is not easy for this syndrome to be diagnosed in time and treated rationally. Misdiagnosis and delayed treatment usually occur. The use of programmable shunts or VP shunts to replace the original shunt is an optimal therapeutic choice. The use of low-pressure shunts to treat arachnoid cysts should be abandoned unless dictated by specific indications.

scholarly journals Double Retromolar Canal: a Case Report

2019 ◽  
Vol 21 (5) ◽  
pp. 474-476
Author(s):  
Ana Paula Tulio Manfron ◽  
Alessandra Soares Ditzel ◽  
Flávia Gasparini Kiatake Fontão ◽  
Luciana Rei Azevedo-Alanis
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Imaging Techniques ◽  
Anatomic Variation ◽  
Anatomical Variation ◽  
Third Molar ◽  
Cone Beam ◽  
Oral Rehabilitation ◽  
Computed Tomography Images ◽  
Retromolar Canal

AbstractThe retromolar canal is an anatomical variation of the mandibular canal. Its neurovascular bundle may extend to areas of the temporalis tendon, and areas of buccinator muscle insertion in the alveolar process at lower third molar region, beside the retromolar fossa. The observation of the retromolar canal in conventional radiographs is limited by the presence of increased bone condensation in the region due to overlapping anatomical structures. The use of three-dimensional imaging techniques, such as cone beam computed tomography can contribute significantly for the treatment planning.Some complications may occur in surgical procedures involving the retromolar area when the retromolar canals are present, such as hemorrhage, failure in anesthesia and injuries to nerve branches. This study reported an unusual case of a double retromolar canal on the left side of the mandible, that led  to the change of the treatment planning in a 54-year-old male patient. Furthermore, the clinical and surgical consequences of these findings in oral rehabilitation were discussed. The cone beam computed tomography was  an important diagnostic tool in the observation of the presence and the exact location of retromolar canal. Retromolar canals may be detected on a panoramic radiograph. However, more precise information about the anatomical variation can be shown on cross sectional cone beam computed tomography images. Keywords: Anatomic Variation. Mandible. Cone-Beam Computed Tomography. ResumoO canal retromolar é uma variação anatômica do canal da mandíbula. Seu feixe vásculo-nervoso pode se estender para áreas do tendão do músculo temporal, áreas de inserção do músculo bucinador e no processo alveolar na região do terceiro molar inferior, além da fossa retromolar. A observação do canal retromolar em radiografias convencionais é limitada pela presença de condensação óssea com sobreposição de estruturas anatômicas. Devido a esse fato o uso de técnicas de imagem tridimensionais, como a tomografia computadorizada de feixe cônico, contribuem significativamente para o planejamento do tratamento. Algumas complicações podem ocorrer em procedimentos cirúrgicos envolvendo a região retromolar quando o canal retromolar está presente, como hemorragia, falha na anestesia e lesões aos ramos nervosos. Este estudo relatou um caso incomum de canal retromolar duplo, do lado esquerdo da mandíbula, causando alterações no planejamento clínico do tratamento de um paciente do sexo masculino de 54 anos de idade. Além disso, as consequências clínicas e cirúrgicas desses achados na reabilitação bucal foram discutidas. Atomografia computadorizada de feixe cônico apresentou-se como importante ferramenta diagnóstica na observação da presença e localização exata do canal retromolar. Canais retromolares podem ser detectados em uma radiografia panorâmica. No entanto, informações mais precisas sobre esta variação anatômica podem ser mostradas em imagens de tomografia computadorizada de feixe cônico. Palavras-chave: Variação Anatômica. Mandíbula. Tomografia Computadorizada de Feixe Cônico.AbstractThe retromolar canal is an anatomical variation of the mandibular canal. Its neurovascular bundle may extend to areas of the temporalis tendon, and areas of buccinator muscle insertion in the alveolar process at lower third molar region, beside the retromolar fossa. The observation of the retromolar canal in conventional radiographs is limited by the presence of increased bone condensation in the region due to overlapping anatomical structures. The use of three-dimensional imaging techniques, such as cone beam computed tomography can contribute significantly for the treatment planning.Some complications may occur in surgical procedures involving the retromolar area when the retromolar canals are present, such as hemorrhage, failure in anesthesia and injuries to nerve branches. This study reported an unusual case of a double retromolar canal on the left side of the mandible, that led  to the change of the treatment planning in a 54-year-old male patient. Furthermore, the clinical and surgical consequences of these findings in oral rehabilitation were discussed. The cone beam computed tomography was  an important diagnostic tool in the observation of the presence and the exact location of retromolar canal. Retromolar canals may be detected on a panoramic radiograph. However, more precise information about the anatomical variation can be shown on cross sectional cone beam computed tomography images. Keywords: Anatomic Variation. Mandible. Cone-Beam Computed Tomography. ResumoO canal retromolar é uma variação anatômica do canal da mandíbula. Seu feixe vásculo-nervoso pode se estender para áreas do tendão do músculo temporal, áreas de inserção do músculo bucinador e no processo alveolar na região do terceiro molar inferior, além da fossa retromolar. A observação do canal retromolar em radiografias convencionais é limitada pela presença de condensação óssea com sobreposição de estruturas anatômicas. Devido a esse fato o uso de técnicas de imagem tridimensionais, como a tomografia computadorizada de feixe cônico, contribuem significativamente para o planejamento do tratamento. Algumas complicações podem ocorrer em procedimentos cirúrgicos envolvendo a região retromolar quando o canal retromolar está presente, como hemorragia, falha na anestesia e lesões aos ramos nervosos. Este estudo relatou um caso incomum de canal retromolar duplo, do lado esquerdo da mandíbula, causando alterações no planejamento clínico do tratamento de um paciente do sexo masculino de 54 anos de idade. Além disso, as consequências clínicas e cirúrgicas desses achados na reabilitação bucal foram discutidas. Atomografia computadorizada de feixe cônico apresentou-se como importante ferramenta diagnóstica na observação da presença e localização exata do canal retromolar. Canais retromolares podem ser detectados em uma radiografia panorâmica. No entanto, informações mais precisas sobre esta variação anatômica podem ser mostradas em imagens de tomografia computadorizada de feixe cônico. Palavras-chave: Variação Anatômica. Mandíbula. Tomografia Computadorizada de Feixe Cônico.

scholarly journals Prevalence and Topography of the Peroneus tertius Muscle: a Study of Human Cadavers

2018 ◽  
Vol 35 (02) ◽  
pp. 106-109
Author(s):  
A. Vieira ◽  
A. Monteiro ◽  
F. Nacur ◽  
R. Coutinho ◽  
T. Direito ◽  
...  
Keyword(s):  
Extensor Digitorum Longus ◽  
Medical Literature ◽  
Anatomic Variation ◽  
Extensor Digitorum Longus Muscle ◽  
Extensor Digitorum ◽  
Lower Limbs ◽  
Classical Literature ◽  
Insertion Point ◽  
Longus Muscle ◽  
Human Cadavers

Introduction The peroneus tertius muscle, also known as fibularis tertius, is classified as an anatomic variation and has been described as inconstant in a wide variety of contemporaneous studies and in the classical medical literature. Its fibers are sometimes mistaken for those of the extensor digitorum longus muscle. In fact, peroneus tertius is detached from the extensor digitorum longus muscle through a tendon inserted into the base of the fifth metatarsal bone, after passing through the frondiform ligament of the extensor retinaculum. Objectives The present study evaluated the prevalence, origin and insertion point of the peroneus tertius muscle in human cadavers. Methods and Results Thirty-two lower limbs, 18.75% of which came from female cadavers, were obtained from two different anatomy laboratories at two separate institutes. The cadaver parts were dissected and photographed. Overall, the muscle was present in 93.75% of the samples and in 100% of the samples from female cadavers. The fibers of the muscle originated in the proximal third of the fibula in 6.68% of cases, in the middle third in 46.66% and in the distal third in 46.66% of cases. Insertion of the tendon was at the base of the fifth metatarsal in 70% of cases and in the space between the fourth and the fifth metatarsal in 30%. Conclusion Therefore, the peroneus tertius muscle was present in the majority of the cadaver parts analyzed; however, the sites of origin and insertion varied. These results contradict data in the classical literature and in contemporaneous studies.

scholarly journals Trigeminal neurovascular contact in SUNCT and SUNA: a cross-sectional magnetic resonance study

Brain ◽  
2020 ◽  
Author(s):  
Giorgio Lambru ◽  
Khadija Rantell ◽  
Emer O’Connor ◽  
Andrew Levy ◽  
Indran Davagnanam ◽  
...  
Keyword(s):  
Morphological Changes ◽  
Aetiological Factor ◽  
Vascular Compression ◽  
Cross Sectional ◽  
Imaging Protocol ◽  
Cranial Autonomic Symptoms ◽  
Data Points ◽  
Trigeminal Root ◽  
Trigeminal Nerves ◽  
Symptomatic Side

Abstract Emerging data points towards a possible aetiological and therapeutic relevance of trigeminal neurovascular contact in short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and perhaps in short lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). We aimed to assess the prevalence and significance of trigeminal neurovascular contact in a large cohort of consecutive SUNCT and SUNA patients and evaluate the radiological differences between them. The standard imaging protocol included high spatial and nerve-cistern contrast resolution imaging acquisitions of the cisternal segments of the trigeminal nerves and vessels. MRI studies were evaluated blindly by two expert evaluators and graded according to the presence, location and degree of neurovascular contact. The degree of contact was graded as with or without morphological changes. Neurovascular contact with morphological changes was defined as contact with distortion and/or atrophy. A total of 159 patients (SUNCT = 80; SUNA = 79) were included. A total of 165 symptomatic and 153 asymptomatic trigeminal nerves were analysed. The proportion of neurovascular contact on the symptomatic trigeminal nerves was higher (80.0%) compared to the asymptomatic trigeminal nerves (56.9%). The odds on having neurovascular contact over the symptomatic nerves was significantly higher than on the asymptomatic nerves [odds ratio (OR): 3.03, 95% confidence interval (CI) 1.84–4.99; P < 0.0001]. Neurovascular contact with morphological changes were considerably more prevalent on the symptomatic side (61.4%), compared to the asymptomatic side (31.0%) (OR 4.16, 95% CI 2.46–7.05; P < 0.0001). On symptomatic nerves, neurovascular contact with morphological changes was caused by an artery in 95.0% (n = 77/81). Moreover, the site of contact and the point of contact around the trigeminal root were respectively proximal in 82.7% (67/81) and superior in 59.3% (48/81). No significant radiological differences emerged between SUNCT and SUNA. The multivariate analysis of radiological predictors associated with the symptomatic side, indicated that the presence of neurovascular contact with morphological changes was strongly associated with the side of the pain (OR: 2.80, 95% CI 1.44–5.44; P = 0.002) even when adjusted for diagnoses. Our findings suggest that neurovascular contact with morphological changes is involved in the aetiology of SUNCT and SUNA. Along with a similar clinical phenotype, SUNCT and SUNA also display a similar structural neuroimaging profile, providing further support for the concept that the separation between them should be abandoned. Furthermore, these findings suggest that vascular compression of the trigeminal sensory root, may be a common aetiological factor between SUNCT, SUNA and trigeminal neuralgia thereby further expanding the overlap between these disorders.

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