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Diogo C Haussen, Ashutosh Jadhav, Leticia C Rebello, Samir Belagaje, Aaron Anderson, Tudor Jovin, Amin Aghaebrahim, Deepak Gulati, Bryan Wells, Michael Frankel, Raul G Nogueira
BACKGROUND AND PURPOSE: Craniocervical fibromuscular dysplasia (FMD) is associated with dissections and with S-shaped curves in the internal carotid artery (ICA). We evaluated the occurrence of S-curves in patients presenting with acute strokes due to ICA steno-occlusive dissections. METHODS: This was a retrospective review of the interventional databases of two academic tertiary-care institutions. The presence of ICA S-shaped curves, C-shaped curves, 360-degree loops, as well as classic FMD and atherosclerotic changes at the ICA bulb and curve/loop was determined...
September 2016: Interventional Neurology
Shuichi Kaneyama, Masatoshi Sumi, Masato Takabatake, Koichi Kasahara, Aritetsu Kanemura, Hiroaki Hirata, Bruce V Darden
STUDY DESIGN: Clinical case series and risk factor analysis of dysphagia after occipitospinal fusion (OSF). OBJECTIVE: To develop new criteria to avoid postoperative dysphagia by analyzing the relationship among the craniocervical alignment, the oropharyngeal space and the incidence of dysphagia after OSF. SUMMARY OF BACKGROUND DATA: Craniocervical malalignment after OSF is considered to be one of the primary triggers of postoperative dysphagia...
October 24, 2016: Spine
Aparna Singhal, Joel K Curé
Time-of-flight magnetic resonance angiography is used for craniocervical arterial evaluation. Absent flow-related signal may be the result of slow flow, complex flow, or focal susceptibility effects. We report a case with complete absence of flow-related signal in the intracranial and cervical vessels due to ferumoxytol infusion given 5 days before magnetic resonance angiography. Ferumoxytol is a newly approved parenteral therapy for iron-deficiency anemia in patients with renal failure and awareness of this drug-magnetic resonance imaging interaction is needed...
October 20, 2016: Journal of Computer Assisted Tomography
Curtis D Westersund, Jeffrey Scholten, Raymond J Turner
OBJECTIVE: Clinical observation and anecdotal reports suggest changes can occur to dental occlusion following intervention with the National Upper Cervical Chiropractic Association (NUCCA) procedure. This case controlled study discerned if occlusion changes are measurable using a dental force plate (T-Scan®) following an adjustment to the craniocervical junction (CCJ). METHODS: A degree of case control was established by active patients being assessed twice prior to and following intervention...
October 20, 2016: Cranio: the Journal of Craniomandibular Practice
Christian Fisahn, Jaspreet Johal, Marc Moisi, Joe Iwanaga, Rod J Oskouian, Jens R Chapman, R Shane Tubbs
INTRODUCTION: Regional neurovascular structures must be avoided during invasive spine hardware placement. During C1 lateral mass screw placement, the C2 nerve root is put in harm's way. Therefore, the current anatomical study was performed to identify techniques that might avoid such neural injury. MATERIALS AND METHODS: On 10 cadaveric sides, dissection was carried down to the craniocervical junction. The C2 nerve root was identified and its distal branches traced out into the surrounding posterior cervical musculature...
October 12, 2016: World Neurosurgery
Fernanda Pasinato, Clarissa C Santos-Couto-Paz, Jorge Luis Lopes Zeredo, Sergio Bruzadelli Macedo, Eliane C R Corrêa
The aim of this study was to verify the effects of induced masseter-muscle pain on the amplitude of muscle activation, symmetry and coactivation of jaw- and neck-muscles during mastication. Twenty-eight male volunteers, mean age±SD 20.6±2.0years, participated in this study. Surface electromyography of the masseter and sternocleidomastoid (SCM) muscles was performed bilaterally during mastication of a gummy candy before and after injections of monosodium glutamate solution and isotonic saline solution. As a result, we observed a decrease in the amplitude of activation of the masseter muscle on the working side (p=0...
September 28, 2016: Journal of Electromyography and Kinesiology
S Yu, L Zhang, J Zheng, Y Xu, Y Chen, Z Song
AIM: To compare the effects of exposure parameters on image quality and radiation dose for craniocervical computed tomography angiography (CTA) using adaptive iterative dose reduction in three dimensions (AIDR 3D) and filtered back projection (FBP) algorithms. MATERIALS AND METHODS: One hundred and eighty patients were divided into three groups; group A (120 kV, 300 mA, FBP), group B (100 kV, automatic mA, AIDR 3D) and group C (80kV, automatic mA, AIDR 3D). Image quality and radiation dose were evaluated for each group...
September 16, 2016: Clinical Radiology
Özer Alkan, Cihan Aydoğan, Sevil Akkaya
INTRODUCTION: Cervical vertebral maturation (CVM) methods have gained popularity to assess growth and development status for orthodontic patients. Although craniofacial and craniocervical structures are known to be associated, there is no evidence in the literature if this relation might negatively affect the accuracy of CVM assessments. Therefore, this study aimed to comparatively investigate the sizes of the 2(nd), 3(rd), and 4(th) cervical vertebrae in adult females (radius union stage of skeletal maturity) who have different sagittal skeletal patterns...
July 2016: Journal of Craniovertebral Junction and Spine
P Vaněk, Ondřej Bradáč, P de Lacy, R Konopková, J Lacman, V Beneš
There are numerous indications for stabilization using instrumentation of the upper cervical spine. This area is comprised of sophisticated anatomy. There is no study describing bony and vascular anomalies of this area in the middle European population. The main aim of this study was to investigate prevalence of any vertebral artery (VA) variations and osseous anomalies in the region of the craniocervical junction in a large sample of Czech patients based on three-dimensional computed tomographic angiography (3D CTA)...
September 13, 2016: Neurosurgical Review
Tae-Lim Yoon, Heon-Seock Cynn, Sil-Ah Choi, Ji-Hyun Lee, Bong-Sam Chio
BACKGROUND: The relationship between forward head posture (FHP) and thoracic kyphosis has been a subject of interest in the rehabilitation field for visual display terminal workers. OBJECTIVE: The aim of this study was to investigate the immediate effects of the craniocervical brace use on craniocervical angle (CCA), thoracic kyphosis angle (TKA), and trunk extensor muscle activity. METHODS: Twelve young male subjects with forward head posture (21...
September 7, 2016: Work: a Journal of Prevention, Assessment, and Rehabilitation
Ronnie Sebro, Thomas DeLaney, Francis Hornicek, Joseph Schwab, Edwin Choy, G Petur Nielsen, Daniel I Rosenthal
BACKGROUND: Chordomas are rare malignancies that primarily affect adults, but also rarely affect pediatric patients. We compared the imaging appearance, demographic and anatomic distributions of adult and pediatric chordomas in a large cohort. METHODS: We performed a retrospective review of medical records of 220 subjects with histologically confirmed chordomas of the axial skeleton and pre-treatment magnetic resonance imaging studies. Age, sex, type of chordoma (conventional, chondroid or dedifferentiated), the anatomic location of the chordoma, as well as whether the lesion was primarily extra-osseous were recorded...
2016: BMC Medical Imaging
Guillaume Leblond, Luis Gaitero, Noel M Moens, Alex Zur Linden, Fiona M K James, Gabrielle Monteith, John Runciman
BACKGROUND: Canine ventral atlantoaxial (AA) stabilization is most commonly performed in very small dogs and is technically challenging due to extremely narrow bone corridors. Multiple implantation sites have been suggested but detailed anatomical studies investigating these sites are lacking and therefore current surgical guidelines are based upon approximate anatomical landmarks. In order to study AA optimal safe implantation corridors (OSICs), we developed a method based on computed tomography (CT) and semi-automated three-dimensional (3D) mathematical modelling using OsiriX™ and Microsoft®Excel software...
2016: BMC Veterinary Research
Elçin Aydin, Mustafa Gök, Asım Esenkaya, Celal Çinar, İsmail Oran
AIM: We aimed to evaluate iatrogenic vascular injuries in craniocervical region and their endovascular management. MATERIAL AND METHODS: Twenty-one patients (nine women, twelve men) with a mean age of 53.6 (range 16-87 years), who underwent endovascular embolization for iatrogenic vascular injury in craniocervical region between December 2000 and October 2015 were included in this retrospective study. Types of iatrogenic injuries, etiologies that caused these injuries and details of endovascular managements were reported...
July 1, 2016: Turkish Neurosurgery
Toshinari Kawasaki, Hitoshi Fukuda, Yoshitaka Kurosaki, Akira Handa, Masaki Chin, Sen Yamagata
BACKGROUND: The patient with SAH by hemorrhagic AVFs usually presents with meningeal signs including headache and nausea, and focal neurological deficit is found in rare cases. In this article, we report a case of acute compressive cervical myelopathy caused by hemorrhagic AVF at the craniocervical junction. CLINICAL DESCRIPTION: A 73-year-old woman was transferred to our hospital for sudden headache and subsequent left hemiparesis. Head CT showed subarachnoid hemorrhage (SAH) exclusively in the posterior fossa, and catheter angiography revealed a perimedullary arteriovenous fistula at the craniocervical junction as a source of the SAH...
August 24, 2016: World Neurosurgery
Muhammad M Abd-El-Barr, Brian D Snyder, John B Emans, Mark R Proctor, Daniel Hedequist
Severe os odontoideum causing ventral brainstem compression is a rare and difficult entity to treat. It is generally accepted that severe os odontoideum causing ventral brainstem compression and neurological deficits warrants surgical treatment. This often requires both anterior and posterior procedures. Anterior approaches to the craniocervical junction are fraught with complications, including infection and risk of injury to neurovascular structures. External traction systems traditionally require long-term bedrest...
August 26, 2016: Journal of Neurosurgery. Pediatrics
Idiris Altun, Kasım Zafer Yuksel
STUDY DESIGN: Retrospective review. PURPOSE: We retrospectively reviewed our patients with ankylosing spondylitis (AS) to identify their patterns of spinal fractures to help clarify management strategies and the morbidity and mortality rates associated with this group of patients. OVERVIEW OF LITERATURE: Because of the brittleness of bone and long autofused spinal segments in AS, spinal fractures are common even after minor trauma and often associated with overt instability...
August 2016: Asian Spine Journal
Joji Inamasu, Riki Tanaka, Ichiro Nakahara, Yuichi Hirose
We report a rare case of dural arteriovenous fistula at the craniocervical junction manifesting as cerebellar haemorrhage, which posed a diagnostic challenge for physicians. A 77-year-old woman with no history of arterial hypertension presented to our Emergency Department with dizziness, and imaging studies revealed a small cerebellar haemorrhage. She was diagnosed with hypertensive intracerebral haemorrhage and conservatively treated. Four months later, she developed subarachnoid haemorrhage, and imaging studies revealed dural arteriovenous fistula at the left C1 dural sleeve...
October 2016: Neuroradiology Journal
Atul Goel, Trimurti Nadkarni, Abhidha Shah, Prashant Sathe, Manoj Patil
BACKGROUND: We evaluated the radiological features of 75 patients having Group B basilar invagination, meaning thereby that there was no evidence of atlantoaxial instability when measured by conventional parameter of abnormal increase in the atlantodental interval. OBJECTIVE: The variability and possible significance of presence of CSF within and outside the confines of neural tissues were specially studied. MATERIAL AND METHODS: During the period January 2008 to May 2015, we encountered 75 cases having Group B basilar invagination...
August 17, 2016: World Neurosurgery
S M Weindling, R D Goff, C P Wood, D R DeLone, J M Hoxworth
Isolated hypoglossal nerve palsy is uncommon, and underlying craniocervical junction degenerative disease has rarely been reported as an underlying cause. To improve understanding of this entity, we present a retrospective series of 18 patients with hypoglossal palsy in whom twelfth cranial nerve compression within the premedullary cistern or hypoglossal canal, or both, was found secondary to craniocervical junction juxta-articular cysts, retro-odontoid fibrous pseudotumors, and osteophytes. The imaging techniques and characteristic craniocervical junction degenerative disease lesion imaging findings presented here might help clinicians interpreting hypoglossal palsy imaging studies avoid perceptual and interpretive errors commonly found in the present series...
August 18, 2016: AJNR. American Journal of Neuroradiology
Qiang Xu, Sheng-Bo Yu, Nan Zheng, Xiao-Ying Yuan, Yan-Yan Chi, Cong Liu, Xue-Mei Wang, Xiang-Tao Lin, Hong-Jin Sui
The suboccipital muscles are connected to the upper cervical spinal dura mater via the myodural bridges (MDBs). Recently, it was suggested that they might work as a pump to provide power for cerebrospinal fluid (CSF) circulation. The purpose of this study was to investigate effects of the suboccipital muscles contractions on the CSF flow. Forty healthy adult volunteers were subjected to cine phase-contrast MR imaging. Each volunteer was scanned twice, once before and once after one-minute-head-rotation period...
2016: Scientific Reports
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