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Cranial remodelling

Jordan W Swanson, Jacqueline A Haas, Brianne T Mitchell, Philip B Storm, Scott P Bartlett, Gregory G Heuer, Jesse A Taylor
There is no clear consensus for the optimal treatment of sagittal craniosynostosis; however, recent studies suggest that improved neurocognitive outcomes may be obtained when surgical intervention imparts active cranial expansion or remodeling and is performed before 6 months of age. The authors consider spring-mediated cranioplasty (SMC) to optimally address these imperatives, and this is an investigation of how helmet orthoses before or after SMC affect aesthetic outcomes.The authors retrospectively evaluated patients treated with SMC and adjunct helmeting for sagittal synostosis...
September 2016: Journal of Craniofacial Surgery
Jan-Falco Wilbrand, Hans-Peter Howaldt, Marcus Reinges, Petros Christophis
OBJECTIVE: Premature craniosynostosis of the lambdoid suture is rare. The use of differential diagnosis to rule out positional occipital plagiocephaly is crucial. Nevertheless, once diagnosed, lambdoid craniosynostosis requires corrective surgery to prevent intracranial harm and aesthetic stigma by significant dyscrania. Operative correction of the lambdoid fusion is often performed by suturectomy and helmet therapy, total occipital remodeling interventions, transposition of occipital bone flaps, or occipital advancement procedures either with or without distraction osteogenesis...
August 6, 2016: Journal of Cranio-maxillo-facial Surgery
Marie-Lise C van Veelen, Marielle Jippes, Julius-Carl A Carolina, Johan de Rooi, Clemens M F Dirven, Leon N A van Adrichem, Irene M Mathijssen
BACKGROUND: Surgery for sagittal synostosis aims at correction of skull shape and restoration of growth potential. Small cranial volume is associated with raised intracranial pressure (ICP). Although many techniques have been described, information on postoperative volume related to early and late remodeling is lacking. METHODS: Between 2004 and 2008, a total of 95 patients were collected who underwent either early extended strip craniectomy or late total cranial remodeling according to age of presentation...
August 9, 2016: Journal of Cranio-maxillo-facial Surgery
Hayelom K Mekonen, Jill P J M Hikspoors, Greet Mommen, S Eleonore Köhler, Wouter H Lamers
Although the intrinsic muscles of the back are defined by their embryological origin and innervation pattern, no detailed study on their development is available. Human embryos (5-10 weeks development) were studied, using Amira3D® reconstruction and Cinema4D® remodelling software for visualization. At Carnegie Stage (CS)15, the epaxial portions of the myotomes became identifiable laterally to the developing vertebrae. At CS16, these portions fused starting cranially to form a longitudinal muscle column, which became innervated by the dorsal branches of the spinal nerves...
August 29, 2016: Clinical Anatomy
G Lakshmi Prasad, Kanthilatha Pai
Hemangiomas are benign, slow-growing tumors composed of sinusoidal blood vessels. Skeletal hemangiomas are uncommon and are mostly vertebral, followed by cranial in location. Cranial hemangiomas are very rarely encountered in children. Authors report a 12-year girl who presented with a painless enlarging mass over the parietal scalp for 3 months. Imaging revealed a left parietal intraosseous lytic mass with a sunburst appearance. Enbloc removal and cranioplasty was performed, and histopathology was suggestive of hemangioma...
August 25, 2016: Neurosurgical Review
David T Martin, Heike Gries, Nick Esmonde, Brian Diggs, Jeffrey Koh, Nathan R Selden, Martin Schreiber, Anna A Kuang
OBJECTIVE: Pediatric cranial vault remodeling for repair of craniosynostosis is associated with significant blood loss and transfusion requirements. Beginning in 2011, the authors evaluated the impact tranexamic acid (TXA) on blood loss and blood product transfusion for children less than 15 months of age undergoing primary surgical repair of nonsyndromic single suture craniosynostosis. METHODS: Following institutional review board approval, the authors performed a retrospective study of all children undergoing surgical correction of craniosynostosis at Oregon Health & Science University from 2005 to 2015...
September 2016: Journal of Craniofacial Surgery
Gaspar Mestres, Marvin E Garcia, Xavier Yugueros, Rodrigo Urrea, Paolo Tripodi, Fernando Gomez, Jordi Maeso, Vicenç Riambau
PURPOSE: The objective of this study is to analyze the original curvature of the aortic arch and thoracic aorta, and how it is modified after the placement of a thoracic endograft. METHODS: We retrospectively analyzed all patients primarily treated for thoracic aortic aneurysms and blunt traumatic aortic injuries by means of an endograft sealed into the aortic arch (zones Z1-Z3) in two different centers (Vascular Surgery Division, Hospital Clinic, UB; and Vascular and Endovascular Surgery Department, Hospital Vall d'Hebron, UAB; Barcelona, Spain), between 2010-2015...
August 11, 2016: Annals of Vascular Surgery
I Ferros, M J Mora, I F Obeso, P Jimenez, A Martinez-Insua
OBJECTIVES: There is controversy regarding the relationship between mandibular position and alterations of the cranial base that provoke a more anterior location of the glenoid fossa. Artificially deformed skulls display marked alterations of the cranial base. This study evaluates mandibular changes as function of the morphology of the cranial base in these skulls. MATERIAL AND METHODS: A geometric morphometric study was performed on lateral cephalometric X-rays of three groups of skulls: 32 with anteroposterior deformity, 17 with circumferential deformity and 39 with no apparent deformity...
November 2016: Orthodontics & Craniofacial Research
Alan F Utria, Joseph Lopez, Regina S Cho, Gerhard S Mundinger, George I Jallo, Edward S Ahn, Craig Vander Kolk, Amir H Dorafshar
OBJECTIVE Due to the changing properties of the infant skull, there is still no clear consensus on the ideal time to surgically intervene in cases of nonsyndromic craniosynostosis (NSC). This study aims to shed light on how patient age at the time of surgery may affect surgical outcomes and the subsequent need for reoperation. METHODS A retrospective cohort review was conducted for patients with NSC who underwent primary cranial vault remodeling between 1990 and 2013. Patients' demographic and clinical characteristics and surgical interventions were recorded...
August 9, 2016: Journal of Neurosurgery. Pediatrics
Justin Drager, Zeeshan Sheikh, Yu Ling Zhang, Edward J Harvey, Jake E Barralet
UNLABELLED: Iron chelators are known activators of the Hypoxia Includible Factor-1α (HIF-1α) pathway, a critical cellular pathway involved in angiogenic responses to hypoxia. Local delivery of these chelators has shown promise in bone tissue engineering strategies by inducing angiogenesis and osteogenesis. Hypoxic microenvironments are also a stimulus for osteoclast differentiation and resorptive activity, a process likely mediated by HIF-1α. In vitro, low doses of the iron chelator Deferoxamine (DFO) has shown to induce HIF-1α mediated osteoclast formation and function...
September 15, 2016: Acta Biomaterialia
Francesco Giovanni Sgulò, Pietro Spennato, Ferdinando Aliberti, Giuliana Di Martino, Daniele Cascone, Giuseppe Cinalli
Chiari malformation type I (CM-I) and hydrocephalus are often associated with complex craniosynostosis. On the contrary, their simultaneous occurrence in monosutural synostosis is extremely rare. The pathophysiological hypothesis is that they may alter posterior fossa growth and lead to cerebellar tonsil herniation also without skull base primary involvement. Hydrocephalus is multifactorial and may be secondary to fourth ventricle outlet obstruction. The management of these cases is quite complex and not well defined...
July 22, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Agnieszka A Książek, Katharyn J Mitchell, Laurent Morax, Colin C Schwarzwald, Simon P Hoerstrup, Benedikt Weber
BACKGROUND: Heterotopic heart transplantation (HHT) in rodent animal models represents an important technique enabling studies on organ transplantation immunology and pharmaceutical development. Recent investigations used nonworking HHT designs, with the left ventricle (LV) bypassed in the anastomosis system. In spite of their principal success, the lack of orthogonal ventricular filling leads to myocardial atrophy. However, when focusing on the cellular and molecular mechanisms involved in the in vivo remodeling of the myocardium or cell-based cardiovascular implants, a nonworking model is suboptimal as it lacks the native-analogous hemodynamic and metabolic situation...
July 20, 2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
M Brodhun, V Stahn, A Harder
Schwannomas are benign Schwann cell-derived tumors of the peripheral nerve sheath often involving the vestibular cranial nerve (vestibular schwannoma). Histologically, they consist of bipolar spindle cells and show a moderate cellularity. Typically, Antoni A regions with a storiform pattern and loose Antoni B regions are intermingled. Verocay bodies are the pathognomonic palisading structures. Malignant transformation is rare. Merlin (schwannomin), the protein product of NF2, is inactivated by mutations, loss of heterozygosity or methylation...
July 15, 2016: HNO
Frank M Smith, Michel Vermeulen, René Cardinal
Long-term spinal cord stimulation (SCS) applied to cranial thoracic SC segments exerts antiarrhythmic and cardioprotective actions in the canine heart in situ. We hypothesized that remodeling of intrinsic cardiac neuronal and synaptic properties occur in canines subjected to long-term SCS, specifically that synaptic efficacy may be preferentially facilitated at high presynaptic nerve stimulation frequencies. Animals subjected to continuous SCS for 5-8 weeks (long-term SCS: n = 17) or for 1 h (acute SCS: n = 4) were compared with corresponding control animals (long-term: n = 15, acute: n = 4)...
July 2016: Physiological Reports
Thom P Santisakultarm, Calvin J Kersbergen, Daryl K Bandy, David C Ide, Sang-Ho Choi, Afonso C Silva
BACKGROUND: Marmosets are a powerful, emerging model for human behavior and neurological disorders. However, longitudinal imaging modalities that visualize both cellular structure and function within the cortex are not available in this animal model. Hence, we implemented an approach to quantify vascular topology, hemodynamics, and neural activity in awake marmosets using two-photon microscopy (2PM). NEW METHOD: Marmosets were acclimated to a custom stereotaxic system...
September 15, 2016: Journal of Neuroscience Methods
F Vaesen, M Thimmesch, J Born, J-P Misson
The lacunar skull is a radiologic description characterised by the presence of lacunae in the cranial vault. Its physiopathology remains up to now poorly understood; it is mostly associated with neural tube defects. The association of a lacunar skull with a craniosynostosis has rarely been described in the literature. The case of a 9-month-old patient presenting a multisutural craniosynostosis with a lacunar skull is reported in this article. The surgical treatment allowed to remodel the skull and to hope for a spontaneous regression of the lacunae...
March 2016: Revue Médicale de Liège
Fabio Mazzoleni, Maria Costanza Meazzini, Giorgio Novelli, Valentina Basile, Carlo Giussani, Alberto Bozzetti
OBJECTIVE: Evaluation of frontal vault symmetry and progressive facial symmetrization in a cohort of patients with hemicoronal single suture synostosis treated with a standardized cranioplasty and rigid fixation. PATIENTS AND METHODS: Fifty-four patients with hemicoronal synostosis operated between 1999 and 2014 were reviewed retrospectively. Pre, immediately postoperative and yearly photographs from the top of the skull and frontal views of the face were taken with the same head position and projection...
August 2016: Journal of Cranio-maxillo-facial Surgery
Hiroki Higashiyama, Tatsuya Hirasawa, Yasuhiro Oisi, Fumiaki Sugahara, Susumu Hyodo, Yoshiakira Kanai, Shigeru Kuratani
The vagus nerve, or the tenth cranial nerve, innervates the heart in addition to other visceral organs, including the posterior visceral arches. In amniotes, the anterior and posterior cardiac branches arise from the branchial and intestinal portions of the vagus nerve to innervate the arterial and venous poles of the heart, respectively. The evolution of this innervation pattern has yet to be elucidated, due mainly to the lack of morphological data on the vagus in basal vertebrates. To investigate this topic, we observed the vagus nerves of the lamprey (Lethenteron japonicum), elephant shark (Callorhinchus milii), and mouse (Mus musculus), focusing on the embryonic patterns of the vagal branches in the venous pole...
September 2016: Journal of Morphology
Michael Alperovich, Michael S Golinko, Z-Hye Lee, Christopher M Runyan, David A Staffenberg
INTRODUCTION: The relationship between nonsyndromic craniosynostosis and neurodevelopment remains controversial. Beyond standardized testing, little data exist about parental perceptions of their child's development. METHODS: Parents of children who underwent cranial vault remodeling for nonsyndromic craniosynostosis from 2011 to 2015 were asked to complete an anonymous survey. RESULTS: Twenty-two parents (31%) completed the survey. Patients included 52...
June 2016: Journal of Craniofacial Surgery
Gerhard S Mundinger, Shady A Rehim, Owen Johnson, Joy Zhou, Anne Tong, Christopher Wallner, Amir H Dorafshar
BACKGROUND: Distraction osteogenesis has been proposed as an alternative to cranial remodeling surgery for craniosynostosis, but technique descriptions and outcome analyses are limited to small case series. This review summarizes operative characteristics and outcomes of distraction osteogenesis and presents data comparing distraction osteogenesis to cranial remodeling surgery. METHODS: A systematic review of the literature was undertaken. Descriptive analysis, operative technical data, outcomes, or postoperative complications of distraction osteogenesis for craniosynostosis were included...
September 2016: Plastic and Reconstructive Surgery
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