المؤلفون: Moncur, Eleanor M.¹, Murphy, Mary¹, Craven, Claudia L.² claudiacraven@nhs.net

المصدر: Journal of Neurosciences in Rural Practice. Apr-Jun2024, Vol. 15 Issue 2, p357-360. 4p.

مصطلحات موضوعية: *FORAMEN magnum, *ARNOLD-Chiari deformity, *TEST validity, *FEASIBILITY studies, *PERCEIVED benefit

مستخلص: Foramen magnum decompression (FMD) is a standard neurosurgical procedure, typically utilized to treat Chiari malformation. The aim of this educational project was to develop and validate a low-cost FMD simulation training model. Mold-based methods were used to develop a prototype. Feasibility was tested during an FMD training session for 17 neurosurgery trainees. Face and content validity were assessed through a Likert Scale. The perceived training benefit was determined using the Physician Performance Diagnostic Inventory Scale (PPDIS). A total of 87.5% successfully removed the C1 arch, 81.3% successfully performed an FMD, and 68.8% avoided injury to the underlying structures. The model scored highly for visual and tactile realism. The median confidence rating on PPDIS significantly improved from early learner to competent. We demonstrate feasibility, content, and face validity. Furthermore, this is a low-cost, portable model that can be easily replicated and used for simulation training. [ABSTRACT FROM AUTHOR]

المؤلفون: kaleem, Shahid¹, Makdoomi, Mohd Arif¹, Ul Rehman, Munib¹, Yousuf, Syed Mubashir¹ s.drmubashir@gmail.com

المصدر: Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research). 2024, Vol. 15 Issue 2, p1086-1091. 6p.

مصطلحات موضوعية: *FORAMEN magnum, *MORPHOMETRICS, *BRAIN stem, *VERNIERS, *SKULL

مستخلص: Background: Foramen magnum is the largest foramen in the skull. It acts as a significant signpost for the several structures that pass through it. Forensic specialists, neurosurgeons, and radiologists alike must have a thorough understanding of the morphometry and morphology of the foramen magnum. The lesion's in ventral proximity to the brain stem and cervicomedullary junction favours the transcondylar approach, which highlights the significance of the foramen magnum's morphometric analysis and accurate measurement of its dimensions. Aims: The present study aims to measure the various morphometric parameters of foramen magnum. Material and Methods: 52 dried human skulls were taken in this study excluding the broken and deformed ones. The anteroposterior and transverse diameters of foramen magnum were measured with the help of a vernier caliper. The area of foramen magnum was calculated using the above parameters. Results: The mean anteroposterior diameter and the transverse diameter of foramen magnum was found out to be 32.60mm ± 1.98mm SD and 27.94mm ± 1.73mm SD, respectively. The mean area of foramen magnum was found out to be 716.41mm2 ± 64.18mm2 SD. Various shapes of foramen magnum were observed. Foramen magnum was observed to have a round shape in 30%, oval in 22 %, Tetragonal in 18%, eggshaped in 16%, irregular in 10%, hexagonal in 4% and pentagonal in 4% of the cases. Conclusion: The current study's data has helped determine the morphology and the morphometry of foramen magnum. This data can prove to be of great importance for neurosurgeons, radiologists, clinical anatomists, and the forensic experts. [ABSTRACT FROM AUTHOR]

المؤلفون: Wada, Yuki¹ yuuuuki_waaaada369@yahoo.co.jp, Hirokami, Jun², Nagasawa, Atsushi¹, Marui, Akira¹, Ohno, Nobuhisa¹

المصدر: General Thoracic & Cardiovascular Surgery Cases. 8/3/2023, Vol. 2 Issue 1, p1-5. 5p.

مصطلحات موضوعية: *PLATYPNEA orthodeoxia syndrome, *FORAMEN magnum, *TIME dilation, *CARDIAC arrest, *ESOPHAGUS

مستخلص: Background: Platypnea-orthodeoxia syndrome (POS) is a relatively uncommon clinical syndrome characterized by dyspnea and deoxygenation accompanying postural changes, such as sitting or standing from a recumbent position. Case presentation: We describe the case of a 76-year-old woman who was hospitalized with dyspnea in the sitting position, which was relieved in the right lateral decubitus position. The patient was diagnosed with POS caused by a patent foramen ovale (PFO), dilation and elongation of the ascending aorta, and pectus excavatum. We performed PFO closure and replacement of the ascending aorta via median sternotomy. The patient's postoperative percutaneous oxygen saturation dramatically increased in the sitting position. Conclusions: Elongated and dilated ascending aorta and pectus excavatum with PFO may be risk factors for POS. In older patients, surgical intervention is an important treatment option for POS caused by cardiac and aortic comorbidities. [ABSTRACT FROM AUTHOR]

المؤلفون: Perrini, Paolo^1,2 (AUTHOR) paolo.perrini@unipi.it, Lorenzini, Daniele¹ (AUTHOR), Vercelli, Alberto¹ (AUTHOR), Perrone, Alessandra¹ (AUTHOR), Di Carlo, Davide Tiziano^1,2 (AUTHOR)

المصدر: Journal of Clinical Medicine. May2023, Vol. 12 Issue 10, p3382. 11p.

مصطلحات موضوعية: *FORAMEN magnum, *ARNOLD-Chiari deformity, *SURGICAL complications, *CEREBROSPINAL fluid leak, *REOPERATION, *AUTOTRANSFUSION of blood, *MYELOGRAPHY

مستخلص: Despite extensive investigations, the choice of graft material for reconstructive duraplasty after foramen magnum decompression for Chiari type I malformation (CMI) is still a topic of discussion. The authors performed a systematic review and meta-analysis of the literature examining the post-operative complications in adult patients with CMI after foramen magnum decompression and duraplasty (FMDD) using different graft materials. Our systematic review included 23 studies with a total of 1563 patients with CMI who underwent FMDD with different dural substitutes. The most common complications were pseudomeningocele (2.7%, 95% CI 1.5–3.9%, p < 0.01, I2 = 69%) and CSF leak (2%, 95% CI 1–2.9%, p < 0,01, I2 = 43%). The revision surgery rate was 3% (95% CI 1.8–4.2%, p < 0.01, I2 = 54%). A lower rate of pseudomeningocele was observed with autologous duraplasty when compared with synthetic duraplasty (0.7% [95% CI 0–1.3%] vs. 5.3% [95% CI 2.1–8.4%] p < 0.01). The rate of CSF leak and revision surgery was lower after autologous duraplasty than after non-autologous dural graft (1.8% [95% CI 0.5–3.1%] vs. 5.3% [95% CI 1.6–9%], p < 0.01 and 0.8% [95% CI 0.1–1.6%] vs. 4.9% [95% CI 2.6–7.2%] p < 0.01, respectively). Autologous duraplasty is associated with a lower rate of post-operative pseudomeningocele and reoperation. This information should be considered when planning duraplasty after foramen magnum decompression in patients with CMI. [ABSTRACT FROM AUTHOR]

المؤلفون: D.E. Ogolo, E.C. Ajare, O. Okwuoma, K.O. Ndukuba, S. Nnama, C.A. Ndubuisi, W.C. Mezue, S.C. Ohaegbulam

المصدر: Brain Disorders, Vol 14, Iss , Pp 100140- (2024)

مصطلحات موضوعية: Foramen magnum, Foramen magnum index, Foramen magnum area, Craniocervical, Neurology. Diseases of the nervous system, RC346-429

الوصف: Background and objectives: While various pathologies affecting the foramen magnum region can have severe consequences, little research has been conducted on the unique morphological patterns in the West African subregion. The study aimed to assess these patterns and their implications for surgeries, comparing them with global standards. Methods: A descriptive study was conducted on 315 patients over a two-year period, excluding those with specific abnormalities. Measurements obtained from cranial 1.5T MRI scans included anteroposterior and transverse diameters of the foramen magnum. From these, the foramen magnum area and index were calculated. The data was analyzed by inferential, comparative and descriptive statistics, and a p value < 0.05 was regarded as statistically significant. Results: On average, the transverse and anteroposterior diameters were 28.51 mm and 33.02 mm for males and 28.39 mm and 33.47 mm for females, with a slightly smaller foramen magnum area in males (7.42 cm²) compared to females (7.47 cm²). Despite these differences, the variations were not statistically significant. However, the foramen magnum indices indicated medium size configuration for females and large size configuration for males, aligning with global trends. Conclusion: The study concluded that West Africans exhibited lower foramen magnum area and indices compared to other regions, with minor differences between sexes. Females tended to have a medium size configuration, while males tended to have a larger size configuration. These findings provide valuable insights for clinicians, highlighting the importance of considering ethno-regional variations in surgical approaches and interventions related to the craniocervical junction.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2666459324000258Test; https://doaj.org/toc/2666-4593Test

الوصول الحر: https://doaj.org/article/0039e5e89723415192035140c6397d69Test

المؤلفون: Vikrant Yadav, Ravi Shankar Prasad, Anurag Sahu, Manish Kumar Mishra, Ravi Shekhar Pradhan

المصدر: Egyptian Journal of Neurosurgery, Vol 39, Iss 1, Pp 1-14 (2024)

مصطلحات موضوعية: Basilar invagination, Chiari malformations, Craniometry, Craniovertebral junction, Foramen magnum, Posterior cranial fossa, Surgery, RD1-811, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

الوصف: Abstract Background The posterior cranial fossa (PCF) and the foramen magnum (FM) are the critical anatomical components of the craniovertebral junction region, which comprise and transmit numerous vital neurovascular structures. So, a fundamental knowledge of the basic radiological anatomy of PCF and FM is of paramount importance in the evaluation of associated pathologies and approaching these areas surgically. The aim of this study is to describe different linear and angular craniometric parameters of PCF, FM and surrounding territory based on reconstructed computed tomography (CT) images. Material and methods This study was conducted in our tertiary care hospital in northern India from the period of January 2023 to June 2023 on 120 patients, and CT screening was done for the head and spine region following a history of head injury. Results In this study, 120 patients were included, of whom 50.83% (n = 61) were females and 49.17% (n = 59) were males. Age ranged from 18 to 70 years with mean age of 43.5 ± 14.08 years. The mean values for linear craniometric parameters of PCF were statistically nonsignificant for different age groups. Statistically significant differences were found for twinning line (TL) (p

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2520-8225Test

الوصول الحر: https://doaj.org/article/c632b47943704db3aa672111b143f25fTest

المؤلفون: Tang, Zhiliang, Liu, Jiao, Li, Jin, Ma, Chunming

المصدر: BMC Complementary Medicine & Therapies; 4/22/2024, Vol. 24 Issue 1, p1-8, 8p

مصطلحات موضوعية: CERVICAL vertebrae radiography, SKULL radiography, NECK, ATLAS (Vertebra), T-test (Statistics), ACUPUNCTURE, VERTEBRAE, DESCRIPTIVE statistics, ACUPUNCTURE points, MASTOID process, CERVICAL vertebrae, SKULL, DATA analysis software, FORAMEN magnum, SPINAL canal

مصطلحات جغرافية: CHINA

مستخلص: Objective: Many acupuncture acupoints are located on the posterior midline of the neck region. The needling depth for acupuncture is important for practitioners, and an unsafe needling depth increases the possibility of damage to the spinal cord and brainstem. Can the safety of acupuncture be assessed by examining bone structures? We focused on this aim to carry out this study. Methods: The shortest distance from the posterior border of the foramen magnum to the line joining both upper ends of the posterior border of the mastoid process was measured on 29 skulls. Distances from the posterior border of the vertebral foramen to the tip of the spinous process and posterior tubercle of the atlas were measured and evaluated from 197 dry cervical vertebrae and 31 lateral cervical radiographs of patient subjects. The anatomic relationships of the vertebral canal with the external occipital protuberance, tip of the spinous process of the axis, tip of the posterior tubercle of the atlas, and upper end of the posterior border of the mastoid process were observed and evaluated via lateral cervical radiography. Results: The shortest distance from the foramen magnum to the line between the mastoid processes was 4.65±1.75 mm, and the distance from the superior border of the vertebral foramen of the atlas to the posterior tubercle was less than the distance from the inferior border. The distance from the superior border of the vertebral canal to the tip of the spinous process in C2-C7 was greater than the distance from the inferior border. The mean lengths of the superior border of the C2 spinous process and the inferior border of the C7 spinous process were greater than 21 mm and 31 mm, respectively. The line from the upper end of the posterior border of the mastoid process to the tip of the C2 spinous process or 10 mm deep to the tip of the C2 spinous process was posterior to the vertebral canal. Conclusions: On the posterior midline of the neck region between the tip of spinous process of axis and external occipital protuberance, if the needle reaches the depth of the line between the upper end of posterior border of mastoid process and the tip of the spinous process of the axis, approximately 10 mm along the spinous process of the axis, the needle is in the safe region. The mean length of the C2-C7 spinous process is suitable to accommodate the needling depth of the adjacent acupoint. Bone structures can be used to effectively assess the safety of acupuncture on the posterior midline of the neck region. [ABSTRACT FROM AUTHOR]

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المؤلفون: Toshiaki Maruyama¹, Toshio Nakamae¹ nakamaet@hiroshima-u.ac.jp, Naosuke Kamei¹, Nobuhiro Tanaka², Yasushi Fujiwara³, Takahiro Harada¹, Nobuo Adachi¹

المصدر: Asian Spine Journal. Apr2023, Vol. 17 Issue 2, p365-372. 8p.

مصطلحات موضوعية: *FORAMEN magnum, *TONSILS, *ARNOLD-Chiari deformity, *DURA mater, *MAGNETIC resonance imaging, *HUMAN abnormalities, *SYRINGOMYELIA

مستخلص: Study Design: A retrospective cohort study. Purpose: We aimed to investigate the surgical results of foramen magnum decompression (FMD) to identify the potential factors associated with syrinx reduction in Chiari malformation type I (CMI). Overview of Literature: The predictive value of preoperative factors for syrinx reduction in patients with CMI remains debatable. Methods: We enrolled patients who underwent microscopic FMD with outer dural layer resection for CMI. The distance from the tip of the cerebellar tonsil to the C2 vertebral endplate on sagittal magnetic resonance imaging (MRI) was defined as the tonsillar distance (TD). Patients who showed a >20% syrinx diameter reduction on the 1-year follow-up MRI were defined as the syrinx reduction group while the others were categorized in the syrinx nonreduction group. Patients with syringomyelia were categorized into the clinically improved and unimproved groups using the Chicago Chiari Outcome Scale. The imaging and clinical parameters were evaluated pre- and postoperatively. Results: This study included 25 patients of whom 19 (76.0%) had syringomyelia. At the 1-year follow-up, the syrinx diameter had decreased in 11 patients (57.8%). The increased TD significantly differed between the syrinx reduction and nonreduction groups. At the 1-year follow-up, 12 and seven patients with syringomyelia were categorized into the clinically improved and unimproved groups, respectively. The clinically improved and unimproved groups showed significant differences in the mean age and increased TD. Conclusions: Postoperative syrinx reduction was significantly correlated with the upward shifting of the cerebellar tonsil in patients with CMI. Our quantitative evaluation of the alterations in hindbrain position after FMD was easily performed and reflects the clinical outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Quach, Eric T.¹ (AUTHOR), Dehdashti, Amir R.¹ (AUTHOR)

المصدر: Journal of Neurological Surgery. Part B. Skull Base. 2023 Suppl, Vol. 84, pS1-S344. 344p.

مصطلحات موضوعية: *FORAMEN magnum, *MENINGIOMA

المؤلفون: Natipong Chatthai, Napakorn Sangchay, Parkpoom Piyaman, Parichart Pattarapanitchai, Sirinart Chomean, Chollanot Kaset

المصدر: Forensic Science International: Reports, Vol 9, Iss , Pp 100371- (2024)

مصطلحات موضوعية: Foramen magnum, FML, FMW, Circumference, Binary logistic regression, Criminal law and procedure, K5000-5582

الوصف: The foramen magnum (FM) occupies a well-protected position, making it particularly intriguing for forensic research. The necessity for methods to estimate sex from cranial fragments becomes evident when only a partial skull is available for identification. The objective of this study was to assess sex differences in anthropometric measurements, including the length of the foramen magnum (FML), width of the foramen magnum (FMW), foramen magnum area (FMA), and circumference, with the aim of developing a binary logistic regression model in Thai cadaveric donors. Sixty adult dry skulls underwent both intraclass and interclass correlation analyses. Subsequently, 240 adult dry skulls of known sex (120 males and 120 females) were meticulously measured and analyzed to determine the optimal threshold for sex determination. Morphometric analysis of the FM was carried out using vernier calipers, and the area of the FM was precisely calculated. The FML, FMW, FMA, and circumference were all found to be significantly larger in males than in females. Furthermore, FM circumference exhibited an AUC (Area Under the Curve) value of 0.908, signifying it as an excellent parameter for sex discrimination. Lastly, binary logistic regression was executed. Significant sex differences in FM circumference were consistently observed, demonstrating an accuracy of 81.62% when validated in 120 dry skulls.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2665910724000203Test; https://doaj.org/toc/2665-9107Test

الوصول الحر: https://doaj.org/article/c8cb3846727e40089df5c270f09c740bTest