Common ocular motor paralysis in a tabetic anatomical examination. A. Papadaki. (Neurological Review, 1904)

Musculi externi eyes are rarely (39: 100) paralyzed in the prodromal period of the tabes. Paralysis is mild and transient at first, but returns severe and prolonged. In this case, all, or almost all, of the motor of the eye is affected, which deviates outward, and ptosis sets in. Temporary paralysis, according to some, are considered to be a consequence of peripheral neuritis, and long-term paralysis is a consequence of damage to the centers of the medulla oblongata. Adamkievitz considered the cause of transient diplopia to be a short-term rush of blood to the nerve trunks and nuclei, and Gweicher - sclerosis of the arteries and ischemia of the motor centers. Dejerine, in a case of isolated paralysis, of a tabetik's eyelid lifter, after opening, found a deep degeneration of his nerve filament, while the trunk of nervi oculomotorii turned out to be unchanged. Because of this, he considers the disease to be peripheral nervo-tabes.

INCIDENCE OF ATLAS BRIDGES AND TUNNELS – THEIR PHYLOGENY, ONTOGENY AND CLINICAL IMPLICATIONS. 26 Incidencia de los puentes y túneles del atlas – Su filogenia, ontogenia e implicancias clínicas

En la vértebra atlas, los puentes posteriores, los puentes laterales y los túneles postero-laterales son las protrusiones óseas que pueden causar presión externa en la arteria vertebral cuando pasa del foramen transverso de la vértebra cervical al foramen magnum del cráneo. Ejemplares que muestran dichas protrusiones fueron clasificadas según tengan puentes del atlas completos o incompletos que pueden predisponer a la insuficiencia vertebrobasilar y al síndrome cervicogénico especialmente durante los movimientos de cuello. El objetivo del estudio es saber la incidencia, ontogenia y filogenia de los puentes del atlas junto con las implicaciones clínicas. Este canal de la arteria vertebral del atlas y la morfología de los puentes fueron estudiados en un total de 60 (120 lados) vértebras atlas humanas completas y secas obtenidas de la colección de esqueletos del Departamento de Anatomía del Government Medical College de Amritsar en Punjab. La incidencia de la impresión de la arteria vertebral (44), la impresión profunda de la arteria vertebral (42) era 71,66%, el puente parcial fue 13,33% y el puente lateral parcial fue 3,33% en el lado derecho y 5% en lado izquierdo. También se observaron doce anillos completos y un túnel 1.66% postero-lateral. La ocurrencia de estos puentes óseos abrazando la arteria vertebral es de suma importancia clínica, pueden causar efecto de comprensión en la arteria vertebral durante la rotación extrema de la cabeza y movimientos de cuello manifestándose en mareos, desmayos, diplopía temporal, vértigo y desórdenes neurológicos. El conocimiento de esta variación es importante para médicos, otorrinolaringólogos, neurólogos y ortopedistas que en la práctica diaria están en contacto con estas enfermedades de la columna vertebral y sus consecuencias. In atlas vertebrae, the posterior bridges, lateral bridges and postero-lateral tunnels are the bony outgrowths which may cause external pressure on the vertebral artery when it passes from foramen transversarium of the cervical vertebra to foramen magnum of the skull. Specimens exhibiting such outgrowths were classified as having incomplete or complete atlas bridges that may predispose to vertebro-basilar insufficiency and cervicogenic syndrome especially in neck movements. The objective of the study is to know the incidence, ontogeny and phylogeny of atlas bridges along with its clinical implications. The groove of the vertebral artery of the atlas and the morphology of the bridges were studied in a total of 60 (120 sides) complete and dry human atlas vertebrae obtained from the skeletal collection of Department of Anatomy,GovernmentMedicalCollege,Amritsar,Punjab. The incidence of impression of vertebral artery (44), deep impression of vertebral artery (42) was 71.66%, Partial ponticuli were 13.33% and Partial lateral ponticuli were 3.33% on right side and 5% on left side. Twelve complete rings and one 1.66% postero-latetal tunnel was also observed. Occurrence of these bony bridges embracing the vertebral artery is of great clinical importance, may cause compression effect on the vertebral artery during extreme rotation of head and neck movements presenting with dizziness, fainting, transient diplopia, vertigo and neurological disturbances. The knowledge of this variation is important for physicians, otolaryngologists, neurologists and orthopaedicians who in every day practice are in contact with the diseases of spine and their consequences.