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anatomy of epidural spinal veins

George H Tse, Umang J Patel, Stuart C Coley, Richard A Dyde
Arteriovenous fistulation between the vertebral arteries to extradural (epidural) veins, termed vertebro-vertebral arteriovenous fistulae, are uncommon diagnoses without established diagnostic algorithms or treatment options. Minimal evidence exists describing the management of this pathology. Endovascular treatment was performed under general anaesthesia by coil occlusion of the vertebral artery from the point of the fistula to the mid-vertebral artery. Repeat magnetic resonance angiographic imaging one week following the procedure confirmed an 80% reduction in the size of the epidural vein and decompression of the cervical spinal cord...
August 2017: Interventional Neuroradiology
Jan-Karl Burkhardt, Michael M Safaee, Aaron J Clark, Michael T Lawton
BACKGROUND: Sacral epidural arteriovenous fistulas (eAVFs) are rare and often misdiagnosed because of the incongruence between the thoracic level of clinical deficits and the sacral location of the offending pathology. Failure to diagnose this lesion delays treatment, resulting in prolonged venous hypertension in the cord, progressive neurological deterioration, and decreased chances of recovery. METHODS: A single-institution case series and the published literature were reviewed...
June 2017: Acta Neurochirurgica
Foram B Gala, Yashant Aswani
Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. In this pictorial essay, detailed anatomy of the posterior epidural space, pathologies affecting it along with imaging pearls to accurately diagnose them are discussed...
July 2016: Indian Journal of Radiology & Imaging
Yasushi Fujiwara, Hideki Manabe, Tadayoshi Sumida, Nobuhiro Tanaka, Takahiko Hamasaki
Retro-odontoid pseudotumors are noninflammatory masses formed posterior to the odontoid process. Because of their anatomy, the optimal surgical approach for resecting pseudotumors is controversial. Conventionally, 3 approaches are used: the anterior transoral approach, the lateral approach, and the posterior extradural approach; however, each approach has its limitations. The posterior extradural approach is the most common; however, it remains challenging due to severe epidural veins. Although regression of pseudotumors after fusion surgery has been reported, direct decompression and a pathologic diagnosis are ideal when the pseudotumor is large...
December 2015: Journal of Spinal Disorders & Techniques
Jan G Myburgh, Robert M Kirberger, Johan C A Steyl, John T Soley, Dirk G Booyse, Fritz W Huchzermeyer, Russel H Lowers, Louis J Guillette
The post-occipital sinus of the spinal vein is often used for the collection of blood samples from crocodilians. Although this sampling method has been reported for several crocodilian species, the technique and associated anatomy has not been described in detail in any crocodilian, including the Nile crocodile (Crocodylus niloticus). The anatomy of the cranial neck region was investigated macroscopically, microscopically, radiographically and by means of computed tomography. Latex was injected into the spinal vein and spinal venous sinus of crocodiles to visualise the regional vasculature...
2014: Journal of the South African Veterinary Association
George J Crystal, M Ramez Salem
Francis A. Bainbridge demonstrated in 1915 that an infusion of saline or blood into the jugular vein of the anesthetized dog produced tachycardia. His findings after transection of the cardiac autonomic nerve supply and injection of the cholinergic blocking drug atropine demonstrated that the tachycardia was reflex in origin, with the vagus nerves constituting the afferent limb and a withdrawal of vagal tone the primary efferent limb. Subsequent investigators demonstrated that the increase in venous return was detected by stretch receptors in the right and left atria...
March 2012: Anesthesia and Analgesia
P V J M Hoogland, W Vorster, R J M Groen, S H Kotzé
Comparative anatomy was used to collect more evidence for a thermoregulatory function of the internal vertebral venous plexus (IVVP). The venous connections of the IVVP were studied and compared in various mammals in order to find evidence for the existence of climate related anatomical adaptations. Humans and vervet monkeys were chosen as representatives of mammals living in moderate climates, the IVVP of the dolphin was studied because this animal is always surrounded by cold water. The springbok was chosen as a representative of mammalian species living under very hot conditions...
May 2012: Clinical Anatomy
Leonardo Rangel-Castilla, Paul J Holman, Chandan Krishna, Todd W Trask, Richard P Klucznik, Orlando M Diaz
OBJECT: Spinal extradural (epidural) arteriovenous fistulas (AVFs) are uncommon vascular lesions of the spine with arteriovenous shunting located primarily in the epidural venous plexus. Understanding the complex anatomical variations of these uncommon lesions is important for management. The authors describe the different types of spinal extradural AVFs and their endovascular management using Onyx. METHODS: Eight spinal extradural AVFs in 7 patients were studied using MR imaging, spinal angiography, and dynamic CT (DynaCT) between 2005 and 2009...
November 2011: Journal of Neurosurgery. Spine
James P Rathmell, Adrien E Desjardins, Marjolein van der Voort, Benno H W Hendriks, Rami Nachabe, Stefan Roggeveen, Drazenko Babic, Michael Söderman, Marcus Brynolf, Björn Holmström
BACKGROUND: Accurate identification of the epidural space is critical for safe and effective epidural anesthesia or treatment of acute lumbar radicular pain with epidural steroid injections. The loss-of-resistance technique is commonly used, but it is known to be unreliable. Even when it is performed in conjunction with two-dimensional fluoroscopic guidance, determining when the needle tip enters the epidural space can be challenging. In this swine study, we investigated whether the epidural space can be identified with optical spectroscopy, using a custom needle with optical fibers integrated into the cannula...
December 2010: Anesthesiology
Inhyung Lee, Norio Yamagishi, Kenji Oboshi, Haruo Yamada
OBJECTIVE: To determine the effects of injection volume and vertebral anatomy on the spread of new methylene blue (NMB) injected into the lumbosacral epidural space in cats. STUDY DESIGN: Prospective experimental study. SAMPLE POPULATION: Sixteen cats. METHODS: Cats were randomly assigned to four groups and received from 0.1 to 0.4 mL kg(-1) of 0.12% NMB in 0.9% saline. Injection was made into the lumbosacral epidural space using a dorsal approach with the cats in sternal recumbency...
July 2004: Veterinary Anaesthesia and Analgesia
John Ayling
The patient who presents with a serious head injury is often very difficult to manage. The airways is of primary concern; adequate ventilation must be provided and aspiration protected against. Recent studies suggest that hyperventilation may be as beneficial as was earlier believed. As the pCO2 level decreases, vasoconstriction occurs. If the level falls too low, cerebral perfusion is restricted, and profound cerebral anoxia may ensue. Current standards call for a ventilatory rate to allow for moderate respiratory alkalosis, in theory to mildly constrict teh vessels but still provide adequate perfusion...
August 2002: Emergency Medical Services
D Parkinson
The lengthy, continuous, slender extradural neural axis compartment (EDNAC), which extends from the coccyx to the orbit, has been not so much discovered as recognized. Through this compartment run arteries, myelinated and unmyelinated nerves, and valveless veins. Adipose tissue is abundant in the orbital and spinal segments, possibly due to movement requirements, although it is very sparse in the skull base segment, the last segment to be recognized as a continuation of the EDNAC, which connects Breschet's veins to the orbit...
April 2000: Journal of Neurosurgery
Q Hogan, J Toth
BACKGROUND AND OBJECTIVES: Important issues regarding the spread of solutions in the epidural space and the anatomy of the site of action of spinal and epidural injections are unresolved. However, the detailed anatomy of the spinal canal has been incompletely determined. We therefore examined the microscopic anatomy of the spinal canal soft tissues, including relationships to the canal walls. METHODS: Whole mounts were prepared of decalcified vertebral columns with undisturbed contents from three adult humans...
July 1999: Regional Anesthesia and Pain Medicine
M Goyal, R Willinsky, W Montanera, K terBrugge
BACKGROUND AND PURPOSE: Arteriovenous malformations (AVMs) of the spine or spinal cord can be characterized as spinal cord AVMs, spinal cord and dural arteriovenous fistulas, and AVMs occurring outside the dura but draining into the epidural veins. The purpose of this study was to review the clinical spectrum, imaging features, and results of treatment of paravertebral arteriovenous malformations (PVAVMs) with epidural drainage. METHODS: The clinical records and images of 10 patients with PVAVMs were analyzed retrospectively for clinical presentation, MR findings, angioarchitecture, pathophysiology, treatment efficacy, and clinical follow-up...
May 1999: AJNR. American Journal of Neuroradiology
P Chaynes, J C Verdié, J Moscovici, J Zadeh, P Vaysse, J Becue
Few studies have been done about the venous vascularization of the spine since neuroradiologic studies in the 1960s and 70s. The aim of this study was to clarify the topography of the internal vertebral venous plexuses in relation to the posterior longitudinal ligament and the dura. The relationships of the vv. were studied at different levels of the spine. The internal vertebral venous system of seven cadavers was injected with a blue bicomponent silicon rubber. It consisted with an anterior and a posterior venous plexus...
1998: Surgical and Radiologic Anatomy: SRA
R J Groen, H J Groenewegen, H A van Alphen, P V Hoogland
Reviewing the literature on the vascular anatomy of the spinal epidural space, it appeared that the knowledge of the internal vertebral venous plexus is limited. Injection studies of the entire internal vertebral venous plexus after application of modern techniques, to the best of our knowledge, have never been performed. Based on the clinical importance of these structures, it was decided to study the human vertebral venous system after Araldite CY 221 injection, in order to update the morphological characteristics of the internal vertebral venous system...
October 1997: Anatomical Record
L L Wiltse, A S Fonseca, J Amster, P Dimartino, F A Ravessoud
With the advent of computed tomography (CT) and magnetic resonance imaging (MRI), visualization of soft tissue structures in the spinal canal, which were previously undetectable, is possible. This study was undertaken to more accurately identify these soft tissue layers and to determine factors such as when is a disc contained and when is it not; in discography, when the disc leaks, into what layer is the contrast going; or when a nuclear fragment creeps upward or downward, just where is it. The works of Fick, Dommisse, Kikuchi, Schellinger, Hofmann, Batson, and Parke were studied...
June 15, 1993: Spine
Y Kubo, S Waga, T Kojima, T Matsubara, Y Kuga, Y Nakagawa
The authors dissected the cervical spine and its surrounding structures from 40 adult cadavers under a surgical microscope. The anterior part of the spine and spinal cord was examined after vertebrectomy. The posterior longitudinal ligament (PLL) consists of two layers; the anterior one is termed the deep layer, and the posterior one is termed the superficial layer. These two layers adhered together loosely. In the lateral portion of the spinal canal, the superficial layer joined the periradicular sheath at the level of the intervertebral disc spaces and joined the dura mater at the level of the vertebral bodies...
May 1994: Neurosurgery
V M Haughton, A Syvertsen, A L Williams
The CT appearance of the vascular, ligamentous, and neural tissues in the spinal canal was studied in 50 patients and 5 cadavers. In some patients, iodinated contrast medium was first injected into the ascending lumbar veins, nucleus pulposus, or theca. Positive identification of spinal soft tissues on the CT image was made by reference to cadaver dissections. The spinal cord, nerves, root sheaths, retrovertebral plexus, epidural and basivertebral veins, posterior longitudinal ligament and ligamentum flavum, intervertebral disks, and vertebral arteries can be demonstrated by CT, indicating its value in the diagnosis of disease of the cord, disk, and epidural space...
March 1980: Radiology
V I Labzin, V Ia Protasov
The veins of the human vertebral canal have a complex internal structure that is stipulated with presence of a large amount of variable in form, size and position formations--plates, trabecules, complex and combined forms, parietal reticularity, cristae and valves. The data on peculiarities of macro-microconstruction of these structures, amount and their localization in various veins and parts of the vertebral canal are presented. Having analysed the data obtained, it is possible to divide the vertebral canal veins into three morphofunctional segments--superior (for the space of C1-C6), middle (C7-Th5) and inferior (Th6 and lower), possessing various hemodynamic characteristics Department of Human Anatomy, Medical Institute, Blagoveshchensk...
December 1984: Arkhiv Anatomii, Gistologii i émbriologii
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