ABSTRACT
Since the hypoglossal nerve is liable to injury during carotid endarterectomy and similar procedures, its blood supply was examined in microinjection studies of human cadavers. The nerve is supplied by arteries that arise from the ascending pharyngeal artery as it exits from the hypoglossal canal, the occipital artery as the nerve passes under its branch to the sternomastoid muscle, direct branches from the external carotid artery, and branches from the ascending pharyngeal artery just near the bifurcation of the common carotid artery. Within and close to the tongue, the nerve is supplied by branches from the lingual artery. Damage to the vessels supplying the nerve may account for some cases of hypoglossal palsy after carotid endarterectomy. Possible mechanisms are ischaemia, thermal or electrical injury from diathermy current conducted to the nerve, or intraneural haematoma from rupturing one or more of these fine vessels.
Subject(s)
Endarterectomy, Carotid , Hypoglossal Nerve/blood supply , Arteries/pathology , Humans , Hypoglossal Nerve Injuries , Ischemia/pathology , Lingual Nerve/blood supply , Lingual Nerve Injuries , Microcirculation/pathology , Microsurgery , Paralysis/etiology , Paralysis/pathology , Postoperative Complications/etiology , Postoperative Complications/pathology , Reference Values , Risk FactorsABSTRACT
The human vagus nerve is supplied by a distinct vagal artery and vein. The artery, which lies on the anterior aspect of the nerve, is reinforced by many small arterioles along its course. These small vessels often lie in the surgical fields in carotid endarterectomy, thyroidectomy and aortic arch aneurectomy. Damage to these vessels may damage the vagus nerve and account for inexplicable cases of vagal palsy following the above surgical procedures.
Subject(s)
Aortic Aneurysm, Thoracic/surgery , Arteries/anatomy & histology , Endarterectomy, Carotid , Thyroidectomy , Vagus Nerve/blood supply , Veins/anatomy & histology , Aged , Aged, 80 and over , Cadaver , Female , Humans , Male , Vagus Nerve/anatomy & histologyABSTRACT
The course of the right recurrent laryngeal nerve (RLN) within the vagus nerve was examined under the light microscope, using horseradish peroxidase. In the higher cervical vagus, i.e. from the base of the skull to the level of the carotid bifurcation, the recurrent laryngeal nerve fibres formed on average 5-6 small separate bundles (15-40 microns in diameter); in the middle cervical vagus, on average from the level of 8-14 mm caudally from the bifurcation, there were fewer bundles with a diameter range of 10-50 microns; in the lower cervical vagus, indicated as being from 14-26 mm caudally from the middle cervical vagus, the bundles merged into a single larger bundle (50-70 microns).
Subject(s)
Recurrent Laryngeal Nerve/anatomy & histology , Animals , Female , Image Processing, Computer-Assisted , Male , Rats , Rats, Wistar , Vagus Nerve/anatomy & histologyABSTRACT
The structural changes in the CNS of cats subjected to periods of 10 and 20 min of eschaemia have been studied. After 10 min of ischaemia the neurons show loss of granular endoplasmic reticulum and vacuolation of the persisting endoplasmic reticulum. After 20 min of ischaemia there is neuronal cell death, some synaptic degeneration. Glial foot processes swell and occlude the lumen of vessels. The significance of these changes is discussed.
