Anatomía clínica-quirúrgica del plexo venoso vertebral del perro: una revisión de la literatura / Clinical and surgical anatomy of the dog vertebral venous plexus: a literature review

El objetivo de la presente monografía, fue actualizar la anatomía del Plexo Venoso Vertebral (PVV) del perro de relevancia clínico-quirúrgica y asimismo evaluar el cumplimiento de la Nómina Anatómica Veterinaria (NAV). Se realizaron búsquedas electrónicas utilizando 9 bases de datos, donde se revisaron un total de 49 fuentes bibliográficas. De éstas, 20 correspondieron a artículos científicos. El criterio de exclusión fue el de publicaciones con más de 10 años de antigüedad, con excepción de libros de anatomía veterinaria de referencia base. Publicaciones que no estuvieran escritas en inglés, español o portugués, fueron también excluidas. En general, en la literatura revisada, existió consenso de cuáles son los componentes del PVV, junto con una escueta descripción de éste. El componente del PVV que es más ampliamente descrito y con mayor dimensión es el Plexo Vertebral Interno Ventral (PVIV). La función de retorno venoso sanguíneo alternativo hacia el corazón es la más nombrada. La no existencia de válvulas en el PVIV, pudiese ser una condición promotora para la metástasis tumoral a través del PVV. A nivel quirúrgico, la hemorragia del PVV, representa un peligro no despreciable para la vida del paciente. Con respecto a lo revisado y discutido, se puede concluir que: i) a pesar de la escasa descripción anatómica del PVV se pudo comprender cómo éste está compuesto ii) el nivel de evidencia que avala las distintas capacidades funcionales del PVV es bajo, no obstante, la información de la presentación de la hemorragia del PVV en las distintas cirugías es mayor iii) las variadas referencias bibliográficas consultadas no respetaron la NAV actual para describir al PVV.

SUMMARY: This monograph aims to provide an update on the anatomy of the Vertebral Venous Plexus (VVP) of the dog with emphasis on its clinical and surgical relevance and to evaluate compliance of terms in the literature with Nomina Anatomica Veterinaria (NAV). Electronic searches were conducted using 9 databases, where a total of 49 bibliographic sources were reviewed. Of these, 20 consisted of scientific articles. Publications with more than 10 years old were excluded from review, except for basic reference veterinary anatomy books. Publications that were not written in English, Spanish or Portuguese were also excluded. In general, in the literature reviewed, there was consensus on what the components of the VVP are, along with a brief description of VVP. The most widely described component of the VVP is the Ven- tral Internal Vertebral Plexus (VIVP). The function of alternative venous blood return to the heart is the most frequently described. The absence of valves in the VIVP could be a promoting condition for tumor metastasis through the VVP. At the surgical level, VVP hemorrhage represents a non-negligible threat to the patient's survival. With respect to what has been reviewed and discussed, it can be concluded that: i) despite the scarce anatomical description of the VVP, it was possible to understand how it is composed ii) the level of evidence that supports the different functional capacities of the VVP is low, however, the information on the ocurrence of VVP hemorrhage in surgical procedures is greater and iii) the various bibliographical references describing the VVP did not comply with the current NAV.

Study Of Incidence, Laterality, And Patency Of Posterior Condylar Foramina In 60 Dry Human Skulls In North Gujarat

Introduction: Posterior Condylar foramina present just behind the occipital condyles, which transmits emissaryvein connecting sub occipital venous plexus with intracranial sinuses.Materials and Methods: Study conducted on 60 dry human skulls. Each skull is observed for incidence, lateralityand patency of posterior condylar foramina. Here patency of foramina is observed by probe.Result: We observed that 77% skulls have presence of condylar foramina and 23% have absence of foramina.50%skulls have bilateral foramina,20% skulls have left sided and 7% have right sided foramina.70% skulls havepatent foramina and 30% skulls have absent patency.Conclusion: There is variation in incidence, laterality and patency of condylar foramina so knowledge of variationin condylar foramina is important for neurosurgeon and ENT surgeon in skull base surgery and also for radiologist.

Anatomical description of internal vertebral venous plexus in horses / Descripción del plexo venoso vertebral interno en equinos

The vertebral venous plexus is a vascular network that runs from the cervical to sacral vertebral canal in the spine of mammals. The objective of this study was to perform an anatomical study of the internal vertebral venous plexus (IVVP) in horses. The spine of five horse specimens (four adults and one foal) was dissected for morphological analysis of the IVVP. The IVVP was observed in the ventral epidural space of the vertebral canal and was composed by two symmetrical longitudinal veins. There was a difference in the IVVP diameter and morphology between foal and adult horses. In all the specimens, the IVVP was more developed at cervical segments, while a decrease in the IVVP diameter was seen in sacral and caudal segments. The cervical IVVP communicated cranially with the basilar, interbasilar and sigmoid sinuses. Transverse communicating branches between left and right IVVP were occasionally observed at the cervical, sacral and caudal vertebral segments. In conclusion, the IVVP in horses is similar to other domestic animals, has transverse connections and is more developed at cervical segment. The diameter of the longitudinal veins decreased and at the caudal segment reaches its thinnest development.

A lo largo de la columna vertebral de los mamíferos se extiende una red de vasos venosos conocida como plexo venoso vertebral interno (PVVI). Se realizó un estudio anatómico del PVVI en equinos mediante disección anatómica, donde se expuso el PVVI de 5 especímenes equinos (4 adultos y un potrillo) para estudio morfologico y registro fotográfico. El PVVI se observó en todo el espacio epidural espinal, conformado por dos venas longitudinales que recorrían el canal vertebral dispuestas de manera romboidal. Se observaron diferencias en el diámetro y morfología del PVVI de adultos en relación a lo observado en potrillos. El PVVI de equinos presentó su mayor desarrollo en el segmento vertebral cervical, disminuyendo el diámetro hacia caudal hasta desaparecer en la zona sacral o caudal. Se apreciaron ramas venosas transversales comunicando las venas longitudinales, destacando los senos venosos presentes en la zona cervical y las ramas transversas comunicantes en los segmentos cervical, sacral y caudal. En conclusión, el PVVI en equinos presentó un mayor desarrollo en la zona cervical y desde la zona torácica hacia caudal el PVVI disminuyó su desarrollo, siendo la zona caudal la más delgada.

Accidental catheterization of epidural venous plexus: tomographic analysis / Cateterização acidental do plexo venoso peridural: análise tomográfica

ABSTRACT BACKGROUND AND OBJECTIVES: Inadvertent venous catheterizations occur in approximately 9% of lumbar epidural anesthetic procedures with catheter placement and, if not promptly recognized, can result in fatal consequences. The objective of this report is to describe a case of accidental catheterization of epidural venous plexus and its recording by computed tomography with contrast injection through the catheter. CASE REPORT: A female patient in her sixties, physical status II (ASA), underwent conventional cholecystectomy under balanced general anesthesia and an epidural with catheter for postoperative analgesia. During surgery, there was clinical suspicion of accidental catheterization of epidural venous plexus because of blood backflow through the catheter, confirmed by the administration of a test dose through the catheter. After the surgery, a CT scan was obtained after contrast injection through the catheter. Contrast was observed all the way from the skin to the azygos vein, passing through anterior and posterior epidural venous plexuses and intervertebral vein. CONCLUSION: It is possible to identify the actual placement of the epidural catheter, as well as to register an accidental catheterization of the epidural venous plexus, using computed tomography with contrast injection through the epidural catheter.

RESUMO JUSTIFICATIVA E OBJETIVOS: A cateterização venosa inadvertida ocorre em aproximadamente 9% das anestesias peridurais lombares com introdução de cateter e caso não seja prontamente reconhecida pode trazer consequências fatais. O objetivo deste relato é descrever um caso de cateterização acidental do plexo venoso peridural e o seu registro por tomografia computadorizada com injeção de contraste pelo cateter. RELATO DE CASO: Paciente feminina, sexagenária, estado físico II (ASA), submetida à colecistectomia convencional sob anestesia geral balanceada e peridural com cateter para analgesia pós-operatória. Durante cirurgia houve suspeição clínica de cateterização acidental do plexo venoso peridural, por refluxo de sangue pelo cateter, fato confirmado pela administração de dose-teste pelo cateter. Feita tomografia computadorizada com injeção de contraste pelo cateter, após o termino da cirurgia. Observado todo o trajeto do contraste desde a pele até a veia ázigo, passando pelo plexo venoso peridural anterior, posterior e veia intervertebral. CONCLUSÃO: É possível a identificação do real posicionamento do cateter peridural, bem como o registro da cateterização acidental do plexo venoso peridural, por meio de tomografia computadorizada com injeção de contraste pelo cateter peridural.

Lumbar Epidural Varix Mimicking Disc Herniation

Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

An Unusual Venous Plexus on Psoas Major Muscle Connecting the Inferior Mesenteric and Testicular Veins

Knowledge of communication between parietal abdominal veins, testicular vein and mesenteric veins is important for Surgeons, Urologists and Radiologists. These communications can result in varicocele or hemorrhoids and may lead to low success rate in hemorrhoid and varicocele surgeries. During routine dissection classes, we observed an unusual large venous plexus on the left psoas major muscle. The venous plexus was unilateral and was formed by many anastomotic venous channels on the psoas fascia and communicated with the left testicular and inferior mesenteric veins. The testicular and inferior mesenteric veins were significantly enlarged below the level of communication with the venous plexus.

Clinic analysis of presacral venous plexus bleeding in pelvic operation / 国际外科学杂志

Objective To investigate the methods of prevention and treatment of presacral venous plexus bleeding in pelvic operation.Methods The clinical data of 8 cases of presacral venous plexus bleeding in pelvic operation from 1998 to 2013 were analyzed.Results All 8 cases succeeded in controlling bleeding,The amount of bleeding was 1 000-4 000 mL,the average amount is 2 600 mL.Conclusions The key to prevention of presacral venous plexus bleeding was thorough familiar with pelvic anatomy and a dexterous technique of careful dissection.Massive hemorrhage occurred direct electric coagulation hemostasis was available,the method was simple.

High-frequency electrocautery in the treatment of massive hemorrhage of presacral venous plexus / 中华消化外科杂志

Objective To assess the clinical value of high-frequency electrocautery in the treatment of massive hemorrhage of presacral venous plexus. Methods The clinical data of 8 patients with presacral venous hemorrhage treated with high-frequency electrocautery from February 2005 to March 2008 were analyzed. Once the presacral venous hemorrhage happened, the bleeding site was pressed with a gauze or finger and the accumulated blood was aspirated. Then, while simultaneously withdrawing the gauze or finger over the bleeding sites, high-frequency electrocautery was applied with a power of 80-100 W to coagulate all the bleeding sites. Results High-frequency electrocautery was used to stop bleeding in the 8 patients, and no electrocautery related complica-tions occurred postoperatively. Conclusions High-frequency electrocautery for massive hemorrhage of presacral venous plexus is simple, efficient and safe.

Thrombolith of the Extradural Vertebral Venous Plexus as a Cause of Lumbar Radiculopathy: A case Report / 대한정형외과학회잡지

Lumbar radiculopathy may occur in the course of many diseases, but abnormalities or pathologic change of extradural vertebral venous plexus is a rare cause of the lumbar radiculopathy. We report a case of lumbar radiculopathy due to thrombolith of the extradural vertebral venous plexus diagnosed by CT and MRI and treated by hemilaminectomy and removal of thrombolith.

Microsurgical Anatomy of the Intracavernous Carotid Artery and Venous Structures

The description of the carotid artery and venous structure in the cavernous sinus, because of their size and location, was very short or even absent in the most anatomical textbooks. But, since the report of a direct surgical approach to the cavernous sinus by Parkinson in 1965, there has been an increasing number of reports of successful direct surgical approaches to the cavernous sinus. With the introduction of microsurgery and the developement of new techinques and surgical approach, a more accurate knowledge of vascular anatomy of the cavernous sinus is not only of theoretical academic interest, but may also have implications. To better study this vascular anatomy, eighty cavernous sinuses from fresh cadavers of adult subjects were dissected under the operating surgical microscope. A red solution of resin was injected to facilitate the dissection, and twenty cavernous sinuses were studied, based on serial sections in the coronal planes for the study of the venous structure of the cavernous sinus. The results of this study were summarized as follows. 1) The most common branch of internal carotid artery in the cavernous sinus was the meningohypophyseal trunk, the largest intracavernous branch, which was presented in 100% of our specimens, the inferior cavernous artery, in 96.3%, and capsular artery, in 13.8%. 2) The ophthalmic artery arised within the paraclinoid portion of the internal carotid artery in 33.8%. In 3.8%, it entered the floor of the optic canal through a foramen in the bone. But there was no intracavernous origin of the ophthalmic artery. 3) The cavernous sinus seemed to be a venous pathway, an irregualr network of venous channel, not a trabeculated sinus.

OBSERVATIONS ON THE VASCULAR ARCHITECTURE OF THE GALL-BLADDER IN THE FULL TERM FETUS UNDER THE SCANNING ELECTRON MICROSCOPE / 解剖学报

The SEM specimens of the blood vessels of the gall-bladder in the full term fetus were produced with the methyl methacrylate cast. The specimens were dryed and gilded with EIKO. IB-3. and then observed under scanning electron microscope. The microvessels of the wall of gall-bladder obviously were divided into three layers, namely: serous vessels, muscular vessels and mucous vessels. The serous and muscular vessels are similar to that of the intestinal canal. However the mucous vessels were characterized by subepithelial capillary networks and veins of large calibre in the lamina propria. The capillary networks were connected directly with the venous plexus by the capillaries. There are fewer arterioles passing and branching among the venous plexuses. Each arteriole was connected to capillary networks. The short capillary was seen frequently between the arterioles and the venous plexus, serving as communication between them.