المؤلفون: Bischof, Antje, Papinutto, Nico, Keshavan, Anisha, Rajesh, Anand, Kirkish, Gina, Zhang, Xinheng, Mallott, Jacob M, Asteggiano, Carlo, Sacco, Simone, Gundel, Tristan J, Zhao, Chao, Stern, William A, Caverzasi, Eduardo, Zhou, Yifan, Gomez, Refujia, Ragan, Nicholas R, Santaniello, Adam, Zhu, Alyssa H, Juwono, Jeremy, Bevan, Carolyn J, Bove, Riley M, Crabtree, Elizabeth, Gelfand, Jeffrey M, Goodin, Douglas S, Graves, Jennifer S, Green, Ari J, Oksenberg, Jorge R, Waubant, Emmanuelle, Wilson, Michael R, Zamvil, Scott S, University of California, San Francisco MS-EPIC Team, Cree, Bruce AC, Hauser, Stephen L, Henry, Roland G

المصدر: Annals of neurology. 91(2)

مصطلحات موضوعية: University of California, San Francisco MS-EPIC Team, Foramen Magnum, Brain, Spinal Cord, Humans, Multiple Sclerosis, Relapsing-Remitting, Atrophy, Disease Progression, Magnetic Resonance Imaging, Prognosis, Prospective Studies, Predictive Value of Tests, Adult, Middle Aged, Female, Male, Multiple Sclerosis, Autoimmune Disease, Neurosciences, Brain Disorders, Neurodegenerative, Aetiology, 2.1 Biological and endogenous factors, Neurological, Clinical Sciences, Neurology & Neurosurgery

الوصف: ObjectiveA major challenge in multiple sclerosis (MS) research is the understanding of silent progression and Progressive MS. Using a novel method to accurately capture upper cervical cord area from legacy brain MRI scans we aimed to study the role of spinal cord and brain atrophy for silent progression and conversion to secondary progressive disease (SPMS).MethodsFrom a single-center observational study, all RRMS (n = 360) and SPMS (n = 47) patients and 80 matched controls were evaluated. RRMS patient subsets who converted to SPMS (n = 54) or silently progressed (n = 159), respectively, during the 12-year observation period were compared to clinically matched RRMS patients remaining RRMS (n = 54) or stable (n = 147), respectively. From brain MRI, we assessed the value of brain and spinal cord measures to predict silent progression and SPMS conversion.ResultsPatients who developed SPMS showed faster cord atrophy rates (-2.19%/yr) at least 4 years before conversion compared to their RRMS matches (-0.88%/yr, p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/31p4n11kTest

المؤلفون: Hetts, Steven W, English, Joey D, Stiver, Shirley I, Singh, Vineeta, Yee, Erin J, Cooke, Daniel L, Halbach, Van V

المصدر: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. 19(4)

مصطلحات موضوعية: Foramen Magnum, Cervical Vertebrae, Cerebral Veins, Spinal Cord, Humans, Central Nervous System Vascular Malformations, Diagnosis, Differential, Magnetic Resonance Angiography, Radiography, Adult, Male, MR angiography, MR imaging, digital subtraction angiography, spinal angiography, spinal dural arteriovenous fistula, spine, vascular malformations, Neurosciences

الوصف: We describe a unique case of bilateral cervical spinal dural arteriovenous fistulas mimicking an intracranial dural arteriovenous fistula near the foramen magnum. We review its detection via MRI and digital subtraction angiography and subsequent management through surgical intervention. Pitfalls in diagnostic angiography are discussed with reference to accurate location of the fistula site. The venous anastomotic connections of the posterior midline spinal vein to the medial posterior medullary vein, posterior fossa bridging veins, and dural venous sinuses of the skull base are discussed with reference to problem-solving in this complex case. The mechanism of myelopathy through venous hypertension produced by spinal dural fistulas is also emphasized.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/5jn3v1hbTest

المؤلفون: Dragoş-Ionuţ Mincă, Petrinel Mugurel Rădoi, Mugurel Constantin Rusu, Corneliu Toader

المصدر: Folia Morphologica. 81:781-784

مصطلحات موضوعية: Adult, Histology, Transverse sinuses, Dura mater, Cranial Sinuses, Occipital sinus, otorhinolaryngologic diseases, medicine, Humans, Retrospective Studies, Sigmoid sinus, Foramen magnum, Transverse Sinuses, business.industry, Anatomy, Middle Aged, medicine.anatomical_structure, Posterior cranial fossa, medicine.vein, Dural venous sinuses, Drainage, Female, Superior Sagittal Sinus, business, Superior sagittal sinus

الوصف: The endothelial-lined dural venous sinuses collect blood from the brain, meninges, and calvaria and drain it to the internal jugular veins. The adult drainage pathway of the venous sinuses confluent is commonly via the transverse and sigmoid sinuses to the jugular bulb. The occipital (OS) and marginal (MS) sinuses are well-represented before birth, in most cases. During a retrospective study of the computed tomography angiograms of a 64 y.o. female was found a rare combination of variants of the posterior fossa sinuses. The confluence of the dural venous sinuses was rhomboidal and drained superiorly the superior sagittal sinus, and inferiorly a well-represented occipital sinus (OS). The transverse sinuses were aplastic, on the right side, and hypoplastic on the opposite side. The OS further drained into the MS which, on each side, emptied into the respective jugular bulb. On each side a condylar vein left the junction of the sigmoid sinus and jugular bulb. Such posterior fossa drainage, exclusively on the OS-MS pathway, should be kept in mind when transections of the venous sinuses are intended during neurosurgical approaches of the foramen magnum. The OS-MS drainage is rather a persisting fetal pattern. The bilateral anatomical exclusion of the transverse sinuses is an added condition to spare the OS and MS.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4d2512aa928f7a54a6b69a80867b4d49Test
https://doi.org/10.5603/fm.a2021.0070Test

المؤلفون: Kei Sato, Keishi Tsunoda, Takayuki Matsuo

المصدر: Child's Nervous System. 38:1817-1820

مصطلحات موضوعية: Adult, Skull Base, General Medicine, Decompression, Surgical, Fibrous Dysplasia, Polyostotic, Magnetic Resonance Imaging, Syringomyelia, Arnold-Chiari Malformation, Young Adult, Pediatrics, Perinatology and Child Health, Humans, Female, Foramen Magnum, Neurology (clinical), Child

الوصف: McCune-Albright syndrome (MAS) and fibrous dysplasia (FD) have been reported to cause Chiari type I malformation (CM1) and skull base invagination (BI).A 6-year-old girl was diagnosed with MAS and FD. She was diagnosed with CM1 at age 8 years, and the syringomyelia had gradually increased by age 20 years. We performed foramen magnum decompression and C1 laminectomy, and the syringomyelia stopped spreading after surgery.This patient underwent long-term radiological observation and morphological evaluations, which revealed that the skull thickening was progressing, while the posterior cranial fossa volume (PCFV) remained unchanged for 14 years. Therefore, although PCFV did not decrease, it was considered to be relatively inadequate due to the increase in brain volume with growth, resulting in posterior fossa overcrowding, causing CM1.In patients with FD/MAS, long-term evaluation of bone thickening, odontoid position, and PCFV is necessary.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1a5637c7d26d5222b870aa84f4b87adaTest
https://doi.org/10.1007/s00381-022-05472-0Test

المؤلفون: Alisa, Arnautovic, Mirza, Pojskić, Kenan I, Arnautović

المصدر: Neurosurgery clinics of North America. 34(1)

مصطلحات موضوعية: Adult, Humans, Foramen Magnum, Plastic Surgery Procedures, Decompression, Surgical, Syringomyelia, Arnold-Chiari Malformation

الوصف: In this study, the authors summarize the current knowledge on epidemiology, demographics, risk factors, and prognostic factors that influence outcomes in patients with adult Chiari malformation type I (CM-I) who underwent posterior fossa decompression surgery with duraplasty. Furthermore, they describe the contribution of their research group to the field of adult CM-I treatment, including association of increased body mass index with severity of CM-I and syringomyelia, relevant surgical anatomy, and surgical technique of 270° microsurgical decompression of foramen magnum. The authors also report on common complications in the literature and describe techniques for prevention of complications.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::ef73e0fd4f28153ee97c8b42677cbcf7Test
https://pubmed.ncbi.nlm.nih.gov/36424069Test

المؤلفون: Mukesh, Bisht, Amandeep, Kumar, Pankaj K, Singh, Ajay, Garg, Dattaraj, Sawarkar, Satish, Verma, Ramesh, Doddamani, Rajesh, Meena, Joseph Devarajan, Leve, Sarat P, Chandra, Shashank Sharad, Kale

المصدر: Neurology India. 70

مصطلحات موضوعية: Adult, Joint Instability, Young Adult, Adolescent, Laminectomy, Humans, Body Weights and Measures, Dura Mater, Foramen Magnum, Cervical Atlas, Decompression, Surgical, Arnold-Chiari Malformation

الوصف: Chiari 1 malformation has crowding at craniovertebral junction (CVJ), treated by Foramen magnum decompression (FMD) but is associated with high failure rates, which is explained by recently introduced concept of central instability. So, we propose a new concept of relieving this crowding without affecting stability.To derive a threshold for coring out of internal surface of C1 posterior arch instead of complete laminectomy accompanying FMD.We prospectively included nine patients with a mean age of 25.33 ± 7.97 years, diagnosed with ACM-1 without AAD, who were operated with FMD and lax duraplasty and C1 laminectomy. The preoperative dural diameter and area covered under the dura at the level of C1 were measured and compared with the postoperative state. Results were analyzed to derive a cut-off threshold which could be drilled from the inner aspect of C1 arch.The postoperative AP diameter of the dura increased statistically significantly from pre-op; however, the AP extension was less than the preoperative diameter with posterior arch included. Likewise, the area spanned by the dura increased statistically significantly from pre-op but was less than the cumulative area of dura with C1 arch included in pre-op. Analyzing all, a mean cut-off of 50.58% was achieved.The authors suggest FMD with partial coring (~50%) of the inner part of arch of C1, instead of full-thickness laminectomy with a wider length of coring as the target, and this will serve the purpose intended, without increasing mobility.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::6fb10f128847b91a912e7ab730e9bda0Test
https://pubmed.ncbi.nlm.nih.gov/36412363Test

المؤلفون: Xiaoyong Xiao, Haijun Li, Wanqi Duan, Shangbing Yang, Huimin Chen, Bo Wang

المصدر: Journal of Craniofacial Surgery. 32:1063-1067

مصطلحات موضوعية: Adult, Foramen magnum, Age changes, Anthropometry, business.industry, Skull, Morphological variation, Brain, General Medicine, Growth spurt, Brain growth, medicine.anatomical_structure, Otorhinolaryngology, Age groups, Child, Preschool, Humans, Regression Analysis, Medicine, Surgery, Foramen Magnum, Child, business, Demography

الوصف: Anthropometrical analysis of the foramen magnum (FM) was conducted on a sample of 32 children and 101 adults excavated from Zaghunluq cemetery dating between 2600 and 1900 cal. yr BP in Xinjiang, China. The FM features of children during age changes and growth spurt periods were explored by comparing the length of the FM, the width of the FM, and the values of the FM index among different age groups. The data presented in this study indicate that the size of the FM was smallest at 2 years old, and the FM size during 5 to 7 years of age was close to that of adults, supporting the view that the size of the 6-year-old skull is close to that of the adult and brain growth appears to terminate at 7 years. The FM likely experiences a growth spurt period during 2 to 5 years of age. Regression equations were established by regression analysis of the length and width of the FM. Study on the morphological variation of the FM provides further information about the growth of children.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ec5468a0007c4df5f5a720ccac6ba0bdTest
https://doi.org/10.1097/scs.0000000000007286Test

المؤلفون: Xinru Xiao, Ye Cheng, Xuesong Bai, Ge Chen, Guolu Meng, Jian Ren, Yuhai Bao, Jiantao Liang, Jie Tang, Gang Song, Mingchu Li, Hongchuan Guo

المصدر: World Neurosurgery. 146:e1242-e1254

مصطلحات موضوعية: Adult, Male, Vagus Nerve Diseases, medicine.medical_specialty, medicine.medical_treatment, Glossopharyngeal Nerve Diseases, Neurosurgical Procedures, Foramen Magnum Meningioma, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Tracheotomy, Meningeal Neoplasms, medicine, Humans, Foramen Magnum, Cranial Nerve Injuries, Gait Disorders, Neurologic, Aged, Foramen magnum, Hoarseness, business.industry, Cranial nerves, Headache, Middle Aged, Debulking, Dysphagia, Surgery, Tumor Debulking, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, Neurology (clinical), medicine.symptom, Deglutition Disorders, Meningioma, business, Organ Sparing Treatments, 030217 neurology & neurosurgery, Jugular foramen

الوصف: Background This study established novel technique nuances in surgery for ventral foramen magnum meningiomas (vFMMs) via a dorsal lateral approach. Methods From July 2012 to July 2019, 37 patients with vFMMs underwent tumor resection surgery and were operated on with a dorsal lateral approach. Two safe zones were selected as the entrance of the surgical corridor. Safe zone I was located between the dural attachment of the first dental ligament (FDL) and the branches of C1; safe zone II lay between the dural attachment of the FDL and the jugular foramen. The tumor was debulked first through safe zone I and then through safe zone II. The tumor was removed through a trajectory from the caudal to cephalad to allow tumor debulking from below and downward delivery, away from the brainstem and lower cranial nerves. Results Thirty-three patients underwent gross total resection, and 4 patients underwent subtotal resection. Four patients transiently required a nasogastric feeding tube. All patients recovered within 3 months postoperatively. Three patients (8.1%) developed permanent mild hoarseness and dysphagia as a result of postoperative damage of cranial nerves IX and X. One patient underwent tracheotomy. No patient experienced tumor recurrence during the follow-up period. Conclusions We established a minimal retraction principle, in which the selection of 2 safe zones as the entrance of the surgical corridor, tumor removal from the inferior to superior direction, and debulking followed by devascularization were the key elements to implement the minimal retraction principle in vFMM surgery.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c80c00dc421ec0ab67c482a476f77d91Test
https://doi.org/10.1016/j.wneu.2020.11.140Test

المؤلفون: Andrew J. Gienapp, Mirza Pojskic, Bawan F. Qaladize, Kenan I. Arnautović, Bruno Splavski, Frederick A. Boop

المصدر: World Neurosurgery. 146:e1103-e1117

مصطلحات موضوعية: Adult, Male, Microsurgery, medicine.medical_specialty, Decompression, Population, Neurosurgical Procedures, Young Adult, 03 medical and health sciences, Myelopathy, 0302 clinical medicine, medicine, Humans, Syrinx (medicine), Foramen Magnum, Karnofsky Performance Status, education, education.field_of_study, Foramen magnum, medicine.diagnostic_test, business.industry, Headache, Magnetic resonance imaging, Middle Aged, Decompression, Surgical, medicine.disease, Magnetic Resonance Imaging, Syringomyelia, Arnold-Chiari Malformation, Surgery, Treatment Outcome, medicine.anatomical_structure, Patient Satisfaction, 030220 oncology & carcinogenesis, Female, Neurology (clinical), Headaches, medicine.symptom, business, 030217 neurology & neurosurgery

الوصف: Objective Chiari malformation type I (CM-I) is a craniocervical junction disorder associated with descent of the cerebellar tonsils >5 mm. The prevalence of CM-I is common, including 0.5%–3.5% in the general population, 0.56%–0.77% on magnetic resonance imaging, and 0.62% in anatomic dissection studies. We sought to measure our surgical outcomes related to resolution/improvement of headaches, neurologic outcomes, and syringomyelia compared with reported adult CM-I studies from 2000–2019. Methods From December 2003 to June 2018, the first author (K.I.A.) performed 270° circumferential decompression on adult (>18 years) patients with CM-I. At admission and follow-up, all parameters were numerically evaluated; headaches were self-reported on the visual analog scale, neurologic condition was evaluated using Karnofsky Performance Status and European Myelopathy Score, and syrinx width (if present) was measured on magnetic resonance imaging by grades I–IV. All parameters were analyzed, compared, and statistically tested. We compared results with our previously reported and updated systematic review of operative adult CM-I studies (studies from 2000 to 2019). Results In our series, 118/121 (98%) experienced headache improvements and 100% experienced neurologic improvements. Complete syrinx resolution was experienced by 35/43 (81%); 8 (19%) showed significant improvement. In data from reported studies (2000–2019), only 79% experienced headache resolution, 77% improvement of neurologic status, and 74% resolution/improvement of syrinx (mean). Conclusions Our modified 270° circumferential microsurgical foramen magnum decompression for adult CM-I appears to be beneficial in improvement of outcomes, namely in resolution of the syrinx, neurologic symptoms, and headaches. We also confirm the association of body mass index with CM-I. Further studies are needed to confirm our results.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ae9ebbdfac4bd52961e79534fd132d7cTest
https://doi.org/10.1016/j.wneu.2020.11.102Test

المؤلفون: Eulâmpio José da Silva Neto, Leandro Martins da Silva, Paula Rejane Beserra Diniz, Severino A. Araújo-Neto, Elayne C.O. Ribeiro, José J.C. Nascimento

المصدر: World Neurosurgery. 152:121-123

مصطلحات موضوعية: Adult, Male, Intraclass correlation, Basilar invagination, 03 medical and health sciences, 0302 clinical medicine, Platybasia, Humans, Medicine, Cutoff, Foramen Magnum, Aged, Observer Variation, Foramen magnum, Receiver operating characteristic, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Confidence interval, Sagittal plane, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, Surgery, Neurology (clinical), business, Nuclear medicine, 030217 neurology & neurosurgery

الوصف: OBJECTIVE To describe the foramen magnum angle (FMA) as a new parameter for basilar invagination (BI) type B. METHODS The FMA was performed on sagittal slice of magnetic resonance imaging (MRI) as a line from the hard palate to the opisthion (angle vertex), and another line from the opisthion to the basion. The MRIs from 31 participants with BI type B and 96 controls were used. Intraclass correlation coefficient, descriptive data, and receiver operating characteristic (ROC) curve were used for statistical analysis at the 95% confidence interval. RESULTS The interobserver agreement of the FMA was 0.952. Patients with BI type B had a FMA significantly greater (25.9° ± 9.3°) than control participants (11.6° ± 4.9°) (P < 0.001). The area under the ROC curve showed a diagnostic value of 0.947. The FMA showed sensitivity 0.900 and specificity 0.854 for the cutoff criterion 17° (P < 0.001). CONCLUSIONS The FMA had an optimal diagnostic value that provided complementary evidence to investigate BI type B.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cd8eefe9ad9a5f928e9b0d777a677bceTest
https://doi.org/10.1016/j.wneu.2021.06.028Test