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posterior fossa

Umut Yilmaz
CLINICAL/METHODICAL ISSUE: The posterior fossa is the location of some specific vascular pathologies and vascular anatomical variants that are important for radiologists to know and recognize. Vascular malformations that are also found in the supratentorial region have some divergent characteristics in the posterior fossa. PRACTICAL RECOMMENDATIONS: Knowledge of the vascular anatomy of the posterior fossa and its variants is important for an understanding of vascular pathologies...
October 21, 2016: Der Radiologe
Annah Lane, Ling Lee, Donna Traves, Andreas Lee
INTRODUCTION: The antenatal diagnosis of open spina bifida (OSB), a neural tube defect, is predominantly made at the second trimester morphology scan by ultrasound detection of structural abnormalities resulting from the associated Chiari II malformation. Evidence has emerged suggesting that these structural abnormalities can be detected earlier, by examination of the posterior fossa as part of the first trimester nuchal translucency scan. In particular, absence of the intra-cranial translucency (IT) of the fourth ventricle has shown promise as a diagnostic marker of OSB, although the sensitivity and specificity of this finding varies widely in the literature...
October 21, 2016: Journal of Medical Imaging and Radiation Oncology
Matthieu Delion, Mickael Dinomais, Philippe Mercier
Surgery of the posterior fossa represents a technical challenge because of the proximity of the vessels of the cerebellum. If the arterial vascularization of the cerebellum is well known, the main arterial variations and the whole venous vascularization are probably under recognized. We describe the vascular organization and the main variations through photographs of colored latex perfused brains, obtained with a surgical microscope. The arterial vascularization of the cerebellum is based on three arteries which all originate from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior and inferior cerebellar artery (AICA), and the posterior and inferior cerebellar artery (PICA)...
October 20, 2016: Cerebellum
Matthias Gmeiner, Helga Wagner, Christoph Zacherl, Petra Polanski, Christian Auer, Willem J R van Ouwerkerk, Kurt Holl
PURPOSE: Very long-term follow-up and outcome are rare for pediatric patients with hydrocephalus and shunt operations. The aim of this study was to determine the long-term mortality rates in these patients. METHODS: Pediatric patients with first shunt operation between 1982 and 1992 were included. For each patient, time and cause of death were determined. Further, patients with first operation from 1982 to 1987 were compared to those first operated from 1988 to 1992...
October 20, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Yu-Chi Wang, Chi-Cheng Chuang, Kuo-Chen Wei, Cheng-Nen Chang, Shih-Tseng Lee, Chieh-Tsai Wu, Yung-Hsin Hsu, Tzu-Kan Lin, Peng-Wei Hsu, Yin-Cheng Huang, Chen-Kan Tseng, Chun-Chieh Wang, Yao-Liang Chen, Pin-Yuan Chen
Atypical and malignant meningiomas are rare. Our aim was to examine the treatment outcomes following surgical resection, and analyze associations between clinical characteristics and overall survival (OS) or relapse free survival (RFS). 102 patients with atypical or malignant meningiomas underwent microsurgical resection between June 2001 and November 2009 were analyzed retrospectively. We compared demographics, clinical characteristics, treatment, and complications. The five-year and ten-year overall survival rates were 93...
October 20, 2016: Scientific Reports
P Papanagiotou, M Politi
Various types of brain tumor can occur in the region of the posterior fossa. Brain metastases in adults are the most common malignancies at this localization. Ependymomas, medulloblastomas and pilocytic astrocytomas occur mostly in children and only rarely in adults. Other tumors that occur in the posterior fossa are meningiomas, schwannomas, hemangioblastomas, brain stem gliomas and epidermoid tumors. Due to the fact that the various tumors of the posterior fossa have different treatment approaches and prognoses, an accurate and specific diagnosis is mandatory...
October 18, 2016: Der Radiologe
Omar N Pathmanaban, Kerry A Burke, Paul Leach, John Thorne, Ian D Kamaly-Asl
BACKGROUND: Positional plagiocephaly is the most common cause of cranial asymmetry. The underlying cause of Chiari-1 malformation has many possible theories, and anecdotally some pediatric neurosurgeons have had experience of severe cases of positional brachycephaly with Chiari-1. However, to date there have been no published cases linking non-synostotic plagiocephaly with Chiari-1 malformation. CASE DESCRIPTION: An 18-month-old boy presented with a head injury...
October 15, 2016: World Neurosurgery
Cameron C Wick, Daniel E Killeen, Michael Clark, Joe Walter Kutz, Brandon Isaacson
OBJECTIVE: Describe the diagnosis and management of spontaneous lateral skull base cerebrospinal fluid (CSF) leaks that originate from the posterior fossa. STUDY DESIGN: Retrospective case review. SETTING: Tertiary university hospital. PATIENTS: Adult patients from 2005 to 2015 who underwent surgical repair of a spontaneous lateral skull base CSF leak with intraoperative confirmation of a posterior fossa leak source...
October 14, 2016: Otology & Neurotology
J Willis Kiessling, Dean A Hertzler, David E M Drucker, Heather S Spader
BACKGROUND: This case report illustrates the need to evaluate the possibility of multiple arterial sources when presented with a frontal epidural hematoma associated with facial trauma. CASE DESCRIPTION: Our patient presented after being struck in the face by a baseball. Computed tomography (CT) of the brain revealed a large frontal epidural hematoma. Intraoperatively, bleeding from a frontal branch of the middle meningeal artery was encountered and cauterized, and the hematoma was removed...
October 14, 2016: World Neurosurgery
Anna Maria Pinto, Valentina Imperatore, Laura Bianciardi, Margherita Baldassarri, Paolo Galluzzi, Simone Furini, Giovanni Centini, Alessandra Renieri, Francesca Mari
Orofacial clefts are the most common congenital craniofacial anomalies and can occur as an isolated defect or be associated with other anomalies such as posterior fossa anomalies as a part of several genetic syndromes. We report two consecutive voluntary pregnancy interruptions in a nonconsanguineous couple following the fetal ultrasound finding of cleft lip and palate and posterior fossa anomalies confirmed by means of post-termination examination on the second fetus. The quantitative fluorescent PCR, the karyotype, and the comparative genomic hybridization-array analysis after amniocentesis were normal...
October 4, 2016: Clinical Dysmorphology
Jordan Nepute, Jinping Lai, Yihua Zhou
Intracranial capillary hemangioma (ICH) is a rare entity, with approximately 24 reported cases in the literature. There are only three reported cases of ICH in an adult male. In this case report, we describe the fourth documented case of ICH in an adult male and, to the best of our knowledge, the first ever documented case of ICH in the posterior fossa of an adult male. We also discuss its imaging appearance and differential diagnosis.
2016: Case Reports in Radiology
Abrar A Wani, Uday S Raswan, Nayil K Malik, Altaf U Ramzan
Dermoid cysts are rare, benign lesions of embryological origin that represent 0.1-0.7% of all intracranial tumors. They are mainly located in the supra tentorial space, especially in the parasellar region. Their location in the posterior fossa remains uncommon. Rupture of intracranial dermoid cysts is a rare phenomenon. We present a case of dermoid cyst, which had ruptured into ventricular system. Computed Tomography and MRI revealed fat in the fourth ventricle, prepontine cistern, and cerebellomedullary cistern...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Radek Frič, Erika Kristina Lindstrøm, Geir Andre Ringstad, Kent-André Mardal, Per Kristian Eide
BACKGROUND: In symptomatic Chiari malformation type 1 (CMI), impaired intracranial compliance (ICC) is associated with an increased cranio-spinal pulsatile pressure gradient. Phase-contrast magnetic resonance imaging (MRI) represents a non-invasive modality for the assessment of the pulse pressure gradient at the cranio-cervical junction (CCJ). We wished to explore how the MRI-derived pulse pressure gradient (MRI-dP) compares with invasively measured pulsatile intracranial pressure (ICP) in CMI, and with healthy controls...
October 14, 2016: Acta Neurochirurgica
Angela Sánchez-Guerrero, Gemma Mur-Bonet, Marian Vidal-Jorge, Darío Gándara-Sabatini, Ivette Chocrón, Esteban Cordero, Maria-Antonia Poca, Katharine Mullen, Juan Sahuquillo
Cerebral microdialysis is widely used in neurocritical care units. The goal of this study was to establish the reference interval for the interstitial fluid concentrations of energy metabolites and glycerol by using the extrapolation to zero-flow methodology in anesthetized patients and by constant perfusion at 0.3 µL/min in awake patients. A CMA-71 probe was implanted during surgery in normal white matter of patients with posterior fossa or supratentorial lesions, and the perfusion flow rate was randomized to 0...
October 14, 2016: Journal of Cerebral Blood Flow and Metabolism
Chandrashekhar R Bande, Akshay Mishra, M K Gupta, Manu Goel, Mayur J Gawande
PURPOSE: Resections in the posterior component of the oral cavity usually lead to severe functional compromise and lower quality of life for patients. Notable advances in reconstruction of the posterior part of the mouth and of the oropharynx have occurred in recent decades. The anatomic and physiologic rehabilitation of the defect to a reasonable outcome with low morbidity and mortality remains the founding basis of any surgical reconstruction, which also holds true for oral oropharyngeal and retromaxillary reconstructions...
September 17, 2016: Journal of Oral and Maxillofacial Surgery
Yi-Ju Ho, Hung-Chi Chen, Shirley H L Chang, Lung-Kung Yeh, David Hui-Kang Ma
BACKGROUND: Sclerocornea, a congenital corneal pathology characterized by bilateral scleralization of the cornea, which can be found in few cases with posterior fossa malformationshemangiomas-arterial anomalies-cardiac defects-eye abnormalities-sternal cleft and supraumbilical raphe (PHACES) syndrome. Presence of vascularization in peripheral cornea and smaller diameter of recipient cornea correlate to poor outcome of penetrating keratoplasty (PKP) in sclerocornea. Here we report a method to preserve limbus during PKP for small, irregular, and scleralized cornea...
October 2016: Medicine (Baltimore)
T Struffert
Many important structures are located in the confined space within the posterior cranial fossa. This article describes the main aspects of the anatomy. As a uniform classification of malformations of the posterior cranial fossa does not exist the main syndromes, such as Chiari malformations, zerebellar hypoplasia and dysplasia are discussed separately.
October 13, 2016: Der Radiologe
Katherine E Weisensee, Richard L Jantz
This research examines the pattern of secular change in the cranial morphology of two populations experiencing the epidemiological transition associated with decreased mortality rates in children, followed by declines in infant mortality and subsequent increases in adult longevity. The two samples examined in this study come from US and Portuguese individuals. The epidemiological transition occurred at different times in the United States and Portugal, with Portugal entering into the transition later than the United States...
January 2016: Human Biology
Lilun Li, Bryan Ward, Margaret Cocks, Amir Kheradmand, Howard W Francis
OBJECTIVE: IgG4-related disease (IgG4-RD) is an idiopathic inflammatory condition that causes pseudotumor formation in single or multiple organs, including those of the head and neck. Temporal bone involvement is rare, with only 3 cases of unilateral temporal bone IgG4-RD described in the literature. We report the first known case of IgG4-RD of bilateral temporal bones and describe its clinical presentation, diagnosis, and treatment. METHODS: The patient was a 52-year-old man with latent tuberculosis (TB) who presented with a 10-year history of bilateral profound hearing loss and vestibular dysfunction...
October 10, 2016: Annals of Otology, Rhinology, and Laryngology
Karen-Helene Støverud, Hans Petter Langtangen, Geir Andre Ringstad, Per Kristian Eide, Kent-Andre Mardal
PURPOSE: Previous computational fluid dynamics (CFD) studies have demonstrated that the Chiari malformation is associated with abnormal cerebrospinal fluid (CSF) flow in the cervical part of the subarachnoid space (SAS), but the flow in the SAS of the posterior cranial fossa has received little attention. This study extends previous modelling efforts by including the cerebellomedullary cistern, pontine cistern, and 4th ventricle in addition to the cervical subarachnoid space. METHODS: The study included one healthy control, Con1, and two patients with Chiari I malformation, P1 and P2...
2016: PloS One
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