A Preliminary Study On Incidence Of Cranial Sutural Bones By 3d Volume Rendering Of Ct Scan In Current Population In Eastern India

Background: Sutural bones are supranumary bones occurring along the sutures and completely surrounded bysutures of the skull. Their number, morphology and location vary in skulls. The knowledge of these bones isimperative in surgery, medicolegal cases involving child abuse or fracture of skulls and for anthropologicidentification of human populations. The studies on sutural bones have traditionally been based on the studiesof dry calvaria which are unreliable for the homogeneity of the population studied. Hence, this pilot study wasundertaken to evaluate the feasibility of 3D volume rendering of CT scan data for study of sutural bones.Method: 3D volume rendering from 64-slice CT scan data from 64 patients was studied for incidence andlocation of occurrence of sutural bones.Results: Overall incidence of sutural bone occurrence was found to be 29.69%. The most common sites forsutural bones, in descending order of occurrence, were found to be parieto-occipital suture, asterion, andlambda.Conclusion: Sutural bone studies in concurrent populations such as this one are rare. The incidence of suturalbones in this study is similar to what another study on concurrent populations has reported. However, locationof occurrence of sutural bones observed in this study was similar to all other sutural bone studies includingthose on dry skulls pointing to probable universality of this statistic. This preliminary study establishes the useof 3D volume rendering of CT scan data to be a valid means to acquire sutural bone data.

Sutural Bones: A Study On Incidence, Laterality And Co-relation With Cephalic Index In Dry Crania Of East Indian Ethnicity

Background: Sutural bones are supranumary bones occurring along the sutures and completely surrounded bysutures of the skull. Their number, morphology and location in skull vary in skulls. The knowledge of these bonesis imperative in surgery, medicolegal cases involving child abuse or fracture of skulls and for anthropologicidentification of human populations. This study was undertaken to examine incidence and pattern of distributionof sutural bones in dry skulls from Eastern India and compare the findings with similar studies across the world.Materials and Method: 180 dry crania were identified as male or female skulls and studied for the incidence andpattern of distribution of sutural bones. Also the Cephalic Index was measured for finding its correlation withthe number of sutural bones appearing in a skull.Results: 124 skulls were identified as male and 56 as female skulls. Overall incidence of sutural bone occurrencewas found to be 72.28% which was essentially similar across sexes. The most common sites for sutural bones,in descending order of occurrence, were found to be parieto-occipital suture, asterion, pterion and lambda.Bregma was the least common site where no sutural bone was encountered. A highly statistically significantfinding was in regard to laterality of sutural bone occurrence. Sutural bones occurring along coronal, parietotemporal, parieto-mastoid, occipito-mastoid sutures and pterion exhibited more than 80% tendency towardsunilateral occurrence while those occurring at asterion exhibited around 70% tendency towards unilateraloccurrence. All these findings, although displayed variable degree of sexual dimorphism, were statisticallyinsignificant for variation among sexes. No correlation between the number of sutural bones with cephalic indexwas found.Conclusion: The findings of this study are in agreement with the findings of many similar suitably poweredstudies across the world.

Posterior reversible encephalopathy syndrome in preeclampsia – A prospective study

Background: Posterior reversible encephalopathy syndrome (PRES) which is a clinic-radiological manifestation sometimes also seen in PE and eclampsia. Materials and methods: 30 cases of preeclampsia or eclampsia cases that had CNS manifestations were studied with MRI before and after neurological recovery. All 100% cases had prompt and total recovery in 1-2 weeks. Results: Headache, Blurring of vision, and vomiting were the common clinical manifestations. Parieto-occipital lobes were commonest sites of cerebral involvement. Conclusion: Most patients with PRES have a suggestive combination of symptoms MRI is crucial for diagnosing, monitoring the course, and assessing treatment effectiveness. Repeated cerebral imaging helps to support the diagnosis. Early recognition and resolution of the underlying cause is the keystone of management.

Microsurgical management of meningiomas in the trigone of the lateral ventricle / 医学研究生学报

Objective Meningiomas in the trigone of the lateral ventricle are characterized by deep location and low inci-dence. A few studies have been done on its treatment at home and abroad. This study was to explore the access,techniques,and clini-cal effect of microsurgery for lateral ventricular trigone meningiomas (LVTM). Methods We retrospectively analyzed the clinical data about 36 cases of LVTM treated by microsurgery in our hospital from December 2011 to December 2015. The operation involved lumbar cistern tube drainage, intraoperative drainage of cerebrospinal fluid, a unilateral parieto-occipital U-shaped cut, approach through the interparietal fissure,a sagittal incision about 3 cm long at the interparietal fissure for exposure and resection of the tumor. We followed up the patients for a mean of 17 months postoperatively and analyzed the results and complications. Results Simpson grade I removal of the tumors was achieved in all the 36 cases. Postoperative complications included homonymous hemianopia in 4 cases, central nervous system infections in 3,secondary epilepsy in 2,subcutaneous hydrops in 2,and intratumoral hemorrhage in 1 (which necessitated a second operation). Extended temporal horn of the right lateral ventricle occurred at 32 months after surgery,which was treated by fistulation. Homonymous hemianopia was improved in 2 of the 4 ca-ses. All the patients were capable of daily life activities and none experienced recurrence. Conclusion Sufficient preoperative evalu-ation of the tumor characteristics,rational selection of surgical approach,and expert operation techniques are the key factors for the mi-crosurgical treatment of meningiomas in the trigone of the lateral ventricle.

Bilateral Cortical Blindness Due to Parieto-Occipital Infarction after General Anesthesia: A case report / 대한마취과학회지

Cortical blindness is characterized by visual sensation loss with retention of pupillary reaction to light, and a normal fundoscopic examination. The suggested causes are emboli, profound hypotension, anemia, and infarction of watershed areas in the parietal or occipital lobe. We experienced a case of cortical blindness with severely reduced visual acuity after penile cancer surgery under general anesthesia. In the acute stage, visual acuity was slightly improved, but over the course of several months, no further improvement in visual acuity occurred. In this case there was no severe hypotension or anemia during the operation. Two days after the operation, electroencephalography (EEG) was performed during the period of blindness and the recording obtained was abnormal, with no alpha rhythm. Biparieto-occipital lucency was found by magnetic resonance imaging (MRI). Therefore parieto-occipital infarction due to seizure, embolus, or thrombosis could be considered a possible etiology. We concluded that cortical blindness can unexpectedly develop perioperatively and postoperatively, and that close monitoring of the patient and adequate management are essential.

Neuropatía óptica traumática. Violencia social / Traumatic optic neuropathy. Social violence

Paciente masculino, 41 años, presenta pérdida visual total en ojo izquierdo, ptosis palpebral e hiporreactividad pupilar izquierda secundaria a impacto de bala en región frontal derecha, localizándose a la fecha en región parietal izquierda luego de trayecto oblicuo, lesionando estructuras ópticas del mismo lado. Trauma craneoencefálico que revela espina irritativa residual por presencia de proyectil. El examen oftalmológico confirmó compromiso total del II par izquierdo, con la consiguiente ceguera y reflejo de marcus gunn incipiente; además afectación parcial del III par izquierdo (ptosis palpebral y trastornos de la reactividad pupilar). En el examen neurológico destaca el buen nivel de conciencia sin signos de focalización a pesar de haber permanecido en coma los 15 días iniciales posteriores al trauma.La fundoscopía destaca palidez del nervio óptico izquierdo. Un tac post-trauma demostró gran edema cerebral, contusión hemorrágica intraparenquimatosa, fronto parieto occipital izquierda. La atrofia óptica post traumática simple resulta como su nombre lo indica de heridas del nervio óptico, fracturas del canal orbitario o por heridas de proyectil. La atrofia no se presenta inmediatamente sino después de varias semanas, aunque la reducción de la visión y hasta la ceguera se producen inmediatamente, como en el caso nuestro.

This is the case of a 41 years old male patient with loss of vision in his left eye, palpebral ptosis, left pupil hyporreactivity, secondary to a bullet impact in the right fore head region; actually this is localized in left parietal region, hurting optical structures of this side.Ophtalmological evaluation reveal total compromise of II left nerve with blindness and incipient marcus gunn reflex. Also we found partial affectation of III left nerve.Neurological evaluation showed a good level of conscience without any complication.Fundoscopy showed optical nerve paleness. CAT scan showed cerebral edema, hemorrhagical contusion.

Cerebral Functional Localization Related to Attentional Work in Patients with Attention-Deficit Hyperactivity Disorder / 신경정신의학

OBJECTIVES: The attentional deficit is a core symptom in attention deficit hyperactivity disorder. The major brain areas related to attention are frontal and parietal lobes. Abnormalities of frontal and parietal lobes in attention deficit hyperactivity disorder have been reported in previous researches. But, most of the researches are based on comparing patients and controls while they are in resting condition. Further research on funtional changes related to performance of attentional task is needed to understand the attentional dysfuntion in attention deficit hyperactivity disorder. In this study, the localized functional changes of the brains related to attentional task in patients with attention deficit hyperactivity disorder and the differences of them between patients and normal controls were examined. Also the effect of the methylphenidate on functional changes related to attentional task in patients with attention deficit hyperactivity disorder was examined. METHOD: Quantitative electroencephalography (QEEG) was applied to examine the fuctional changes related to attentional task. Subjects of this study consisted of 20 patients with attention deficit hyperactivity disorder and 20 controls who were matched age, sex, handedness, intelligence. QEEG was recorded on eye open resting condition, and on performing computerized attentional task. In cases of patients, after taking of methylphenidate, QEEG was recorded on both conditions. RESULTS: 1)In attention test, normal controls had better scores in response time and variabilities of response time than those of patients with attention deficit hyperactivity disorder without taking methylphenidate. After taking medication, scores of omission, response time and variabilities of response time were significantly improved, comparing to scores without taking medication. No differences were recognized between the controls and patients with taking medication in scores of attention test. 2)In resting condition, spectral EEG revealed baseline activity levels of patients were significantly increased comparing to those of controls. 3)Analysis of delta wave revealed that amplitudes of controls were significantly elevated in parieto-occipital area during performance of attentional task. But in patients, localized activated area related to attentional task was not remarkable. 4)Theta activity of controls were significantly elevated in right frontal, right temporal, and both parieto-occipital areas during performance of attentional task. But in patients without taking medication, localized activated area related to attentional work was not remarkable. After taking medication, right frontal, right temporal, and both parieto-occipital areas were significantly activated. 5)Alpha activities of controls were significantly increased in parieto-occipital area during performance of attentional task, but those of patients without taking medication were increased in broad area. 6)Beta activities of controls were significantly increased in frontal area during attentional performance, but those of patients without taking medication were significantly increased in most of the brain areas. After taking medication, significantly increased activities related to attentional task were recognized in left frontal, and both temporal areas. Localized activated patterns similar to those of controls were recognized. CONCLUSION: Based on the results of this research, it is suggested that patients with attention deficit hyperactivity disorder have increased baseline brain activity. In controls, brains showed localized response to a attentional stimuli, and functional changes related to attentional stimuli were recognized in frontal, and parieto-occipital areas. But, patients failed in showing appropriate localized activated response to attentional stimuli. It is concluded that frontal and parieto-occipital areas have some deficit responsible for the attentional dysfunction of attention deficit hyperactivity disorder.

A Case of Epidermoid in the Third Ventricle: Case Report

A case of a third ventricular epidermoid is presented, which was diagnosed by conray ventriculography and computerized tomography. The tumor was subtotally removed through a low parieto-occipital approach and ventriculo-peritoneal shunt was performed. The epidermoid of the third ventricle is extremely rare and only a few cases have been reported in the literatures. It's incidence, preoperative diagnosis, surgical technique and complications are briefly reviewed.