Internal carotid and vertebral arteries diameters and their interrelationships to sex and left/right side.

BACKGROUND: The available anatomical data about diameters of inflow vessels to the circle of Willis reflect various diagnostic and imaging methods used, sample sizes, levels of measurements, and lack of possible specific ethnic, regional or genetic data. Additionally, the data are often without distinctions about left-right or sex. MATERIALS AND METHODS: Therefore, using computed tomography angiography (CTA) we investigated diameters of internal carotid (ICA) and vertebral (VA) arteries in 70 adult persons (28-75 years) of both sexes (34 males and 36 females), at predefined cervical parts of ICA (2 cm above carotid bifurcation) and of VA (5 mm before VA penetrated the dura). RESULTS: Sex differences were expressed as highly significant larger diameters of left VA (LVA) in males (3.49 mm) than in females (3.00 mm), and as significantly larger diameters of right VA (RVA) in males (3.20 mm) than in females (2.82 mm), as well as of right ICA (RICA) diameters in males (5.04 mm) than in females (4.56 mm), but without such difference for left ICA (LICA) between males (4.82 mm) and females (4.60 mm). Intrasex (in males or in females) left-right differences of ICA and VA diameters were not significant. Significant positive correlations were found in females between RICA and RVA, and in males between RICA and LICA. Calculated mean sum of ipsilateral diameters of right arteries (RAA = RICA + RVA) was in males 8.25 mm, in females 7.38 mm, and of left arteries (LAA = LICA + LVA) was in males 8.31, and in females 7.60 mm, without statistically significant difference between RAA and LAA, neither in males, nor in females. Statistically highly significant larger sums of diameters were in males than in females for both, RAA and LAA. CONCLUSIONS: Our findings, as the first data about diameters of ICA and VA systematically obtained by CTA in the population of western Balkans, suggest that in the studies of these diameters is absolutely necessary to analyse separately the data for sex, and to use defined standard levels.

Sex and level differences in the diameters of extradural segment of vertebral artery: computed tomography angiographic study.

BACKGROUND: We investigated diameters of prevertebral - V1, and atlantic - V3 parts of extradural segment of vertebral artery (VA). Variable results from the literature about VA diameters reflect variety of diagnostic and imaging methods, various sample sizes, different levels of measurements, and lack of possible specific ethnic, regional or genetic data. Additionally, the data are often without distinctions of left-right or of sex. MATERIALS AND METHODS: For this computed tomography (CT) angiographic study 91 adult people (182 VAs) of both sexes (47 males and 44 females) and of age between 33 and 75 years were selected. Diameters were measured at fixed predefined points of VA, marked as inferior (A) point (at V1 part in region of VA origin), as middle (B) point (the end of V1 part), and superior (C) point, at V3 part - 5 mm before VA penetrated the dura. Inferior (A) and middle (B) points actually represent locations at beginning (A) and at terminal (B) regions of V1 part of VA, and superior point C represents terminal part of V3. RESULTS: In total sample ipsilateral (both left [L] and right [R] sided) diameters on investigated levels of VA showed progressive and highly significant decreases. The mean values were on the right side at point A - 3.63 mm, at B point - 3.31 mm, and at C point - 3.08 mm. On the left side, mean values were at point A - 3.76 mm, at B point - 3.50 mm, and at point C - 3.21 mm. Pattern of increasing sex differences in diameters of VA, was ranging from no differences (point A), trough significant (point B), to highly significant differences (point C). For inferior point (A) we did not find significant differences in VA diameters between males (R 3.78 mm; L 3.89 mm) and females (R 3.50 mm; L 3.62 mm), in middle (B) point sex differences were significant (males: R 3.44 mm, L 3.66 mm; females: R 3.18 mm, L 3.33 mm) and in most superior point (C) differences were highly significant (males: R 3.278 mm, L 3.39 mm; females: R 2.88 mm, L 3.01 mm). However, we did not find significant intrasex (in males or in females) left-right differences in mean values of VA diameters for all three investigated levels. CONCLUSIONS: Our findings, as the first data about diameters of VA systematically obtained by CT angiography in the population of western Balkans and wider, suggest that in design of future studies of VA diameters is necessary to analyse separately the data for sex, as well as to use defined standard levels.

Variability of the vertebral artery origin and transverse foramen entrance level - CT angiographic study.

BACKGROUND: Vertebral artery (VA), the main element of the posterior brain circulation, has many anatomical variations which generally were widely investigated. However, available data vary in wide ranges, reflecting very different sample sizes, lack of data about left-right or sex differences, and about possible ethnic, regionally specific or genetic differences. MATERIALS AND METHODS: Certain new findings suggest possible involvement of some environmental factors in VA variations. Accurate anatomical data about VA variations in different regions of the world, including Balkans countries, are still lacking. Therefore we investigated morphological variability of VA origin and its entrance level into cervical transverse foramina in population of Republika Srpska (Bosnia and Herzegovina), including data about the sex and side. RESULTS: Anatomy of VA was investigated in 112 persons (224 arteries) of both sexes (58 males, 54 females; age 19-83 years), using 64-slice computed tomography (CT) scanner. Origin of VA from subclavian artery (SCA) we found in 95.08% of arteries (52 males, 49 females). Only in 1 (0.45%) male left VA and left SCA had an specific origin from aortic arch (AA), which we named as an "common area of origin". All other observed variations in origin were only of left VA, originating from AA in 4.47% (5 males, 5 females). Left VA most often (usual) entrance level into transverse foramen we found at C6 (87.5%), followed by C5 (8.93%), C4 (3.12%), and in 1 case at level C7 (0.45%). Entry levels at C5, both on right and on the left side, were three times more frequent in males than in females. CONCLUSIONS: Wide ranges of differences between the data we obtained on a sample in Republika Srpska (Bosnia and Herzegovina) and the data from many other studies require further and wider investigations.

Sex differences of human corpus callosum revealed by polar coordinate system: magnetic resonance imaging study.

BACKGROUND: Evaluation of morphological and size changes related to various pathological conditions of the corpus callosum (CC) requires the data about sex dimorphism of the CC. The purpose of our study is to define potential morphological sex differences of the CC by the use of polar coordinate system as a system of measurements. MATERIALS AND METHODS: After division of the CC into three equal segments by the use of polar coordinate system, we investigated the length of the hemisphere (A-A'), the CC size as its midsagittal section area (CCA), the size of its segments (C1, C2, C3), thickness of the thinnest part of the CC (TCC) and the angular coordinate (a angle) of dorsal point of the TCC in a sample of 30 human brains magnetic resonance images (15 males and 15 females, age 20-50 years). RESULTS: We found significantly larger CCA, C3 segment and the TCC in males. Statistically significant correlation in both, males and females, was found between parameters of the CCA and of all of its segments (C1, C2, C3), the C1 and C2, the C2 and C3 segments, as well as like as between the C2 and TCC. Sex differences were also in findings of significant correlation between the C1 and C3 segments, between CCA and TCC, and of significant negative correlation between the a angle and A-A' only in females. CONCLUSIONS: We concluded that the use of polar coordinate system appropriately reflects the anatomical and encephalometric characteristics of human CC.

[Morphometric parameters of the intercondylar notch, gender and age differences].

INTRODUCTION: Narrow intercondylar notch of femur can lead to lean anterior cruciate ligament on femur's condyle, constraint and rupture. PURPOSE: Purpose of this study is description and comparasion gender and oldage differencies of morphometric factors of intercondylar notch important for rupture LCA. METHOD: The measurements were taken on 50 cadaverous knees (32 male and 18 female) with intact anterior cruciate ligament, aged from 15 to 53 years. We measured intercondylar height and epicondylar width, intercondylar width, width of lateral and medial condyle in level of popliteal sulcus and on the widest place of the distal part of femur. We calculated notch width (NWI) and notch shape (NSI) indices from absolute measurements. RESULTS: Notch width and epicondylar width, have larger values (p < 0.01) on the male (22.3 i 79.6 mm) than the female (18.2 i 68.7 mm). There is no statistical significant differences (p < 0.05) about notch width and notch shape indices between male (NWI: 0.28; NSI: 0.77) and female (NWI: 0.27; NSI: 0.68). Aging epicondylar width rise.

[Anterior cruciate ligament (ACL)].

The anterior cruciate ligament or ACL (ligamenturn cruciatum anterius) is often injured, either alone or within complex ligament injuries of the knee. Therefore, the knowledge of detailed anatomic (macro- and micro-morphological) characteristics of this ligament is of key importance in therapy. The anatomy, structure, insertions, vascularization and inervation of the anterior cruciate ligament of the knee are described from the aspect of modern treatment and rehabilitation methods.

Third coronary artery in monkey heart.

Investigations were carried out on 55 monkey (Cercopithecus aethiops, Macaca fascicularis) hearts by stereomicroscopic dissection and measurements. Latex-injected specimens and corrosion casts showed that, as in humans, the hearts were usually (in 98.2% of the cases) supplied by two coronary arteries (CAs)--the left (LCA) and the right coronary artery (RCA), and occasionally (in 1.8% of the cases) also by a third one (TCA). Furthermore, the orifice of the TCA was situated in the right aortic sinus at the same level as the RCA and 0.2 mm in front of it. The LCA and the RCA originated from the corresponding aortic sinuses and the external diameter of the LCA was greater [average: 1.65+/-0.39 (SD) mm] than that of the RCA [average 0.94+/-0.15 (SD) mm] and the TCA (0.8 mm). The LCA orifice was more often above (76.3%) than below the free edge of the left aortic valve leaflet. The longitudinal axis of the aortic root and of the initial part of the LCA formed an angle of 45-120 degrees (average: 52 degrees). The orifice of the RCA was usually above (82.3%) the free edge of the right aortic valve leaflet, and less frequently below it (17.7%). The longitudinal axis of the aortic root and of the initial part of the RCA formed an angle of 70-150 degrees (average: 103 degrees). The resemblance of monkey CAs to their human counterparts make them a suitable model for experimental studies on coronary circulation.

Different neuronal and glial cell groups in corticomedial amygdala react differently to neonatally administered estrogen.

The percentage of labeled neurons and glial cells in the phylogenetically older corticomedial part of the amygdala was investigated in control and estrogen-treated rats using [3H]thymidine autoradiography. Newborn, three-day-old female and male Wistar rats were treated with a single dose of 1 mg of estrogen and killed at the age of 10 days. The percentage of labeled neuronal and glial cells was determined by stereological methods in the medial, cortical and central nuclei, respectively. In treated male rats, the percentage of labeled neurons and glial cells in these nuclei was significantly greater on the 10th day of life as compared to controls, except for glial cells in the nucleus centralis. In treated female rats, the percentage of labeled neurons in all three nuclei was comparable to controls, while the percentage of labeled glial cells was increased in the nucleus medialis, decreased in the nucleus centralis and unchanged in the nucleus corticalis. Our results indicate clear sex- and region-specific differences in the reactivity of both neurons and glia to neonatally administered estrogen.

The neurons of the human magnocellular septal nuclei: a Golgi study.

The morphology of neurons in the magnocellular septal nuclei (medial septal and diagonal band nucleus) were studied in frontal sections of 15 human brains by means of the Golgi method. We classified neurons in the diagonal band nucleus according to their size and morphology into four types: type I--multipolar neurons, type II--fusiform neurons, type III--triangular neurons and type IV--fusiform multipolar neurons. The neurons of the medial septal nucleus we classified into two types: type I--multipolar neurons and type II--fusiform neurons. Our results indicated greater morphological variability of neurons in the human diagonal band nucleus than in the medial septal nucleus.

[Morphologic asymmetry of the frontal lobe of the cerebral hemisphere in man]. / Morfoloska asimetrija frontalnih reznjeva hemisfera mozga coveka.

The morphology and the left-right asymmetry of the frontal lobe convexity (sulcus frontalis superior and inferior, sulcus precentralis, gyrus precentralis, gyrus frontalis superior and medius) were studied on 19 formaline fixed human brains. During the study, the gyral and sulcal patterns were marked as similar, partially similar or different. Sulcal patterns on the left and right side were completely different (in at least more than half) in the greatest number of cases. Gyral patterns were also asymmetric (mirror image analysis). However, using the "essential gyral line"--the line indicating longitudinal gyral axis--the results changed dramatically. The majority of patterns appeared to be very similar, indicating that the method of analysis largely influences the results of morphological studies of human brain asymmetry. This explains different findings reported in the literature. We suggest that the use of the "essential gyral line" provides standardized method of morphological analysis, which was not available up to date.

Golgi morphology of the neurons in frontal sections of human interthalamic adhesion.

The Golgi morphology of the neurons in the human interthalamic adhesion (IA, which is not present in every human brain) is very variable. Four types of Golgi-impregnated neurons were found in the adult human IA: (1) fusiform neurons (most characteristic of the human IA); (2) neurons with an oval perikaryon; (3) triangular neurons (rarely found), and (4) multipolar neurons (polygonal perikaryon and at least 4 primary dendrites). Fusiform neurons, as well as triangular and multipolar ones, belong to the isodendritic type, but the neurons with oval perikarya do not.

Anatomy of the pericallosal pial plexus in man.

Fine arterial branches on the superior surface of corpus callosum were investigated on 22 human brains under stereomicroscope. These branches were directed toward: 1. the upper surface of corpus callosum (3-6 branches, mean 8), 2. the depths of the sulcus corporis callosi (4-13 branches, mean 7), and 3. the cingulate gyrus (1-10 branches, mean 5). All the vessels composing the pericallosal pial plexus have a uniformed caliber of 0.9-0.6 mm at their origins, and 0.7-0.3 mm after branching. In 9 cases a longitudinal vessel within the stria longitudinalis medialis, connected with the pial plexus was found. Important details of morphology of this plexus and their significance are discussed.

Alexia with agraphia.

The authors presented a case of relatively pure syndrome of alexia with agraphia in a patient speaking Serbo-Croatian language. Reading disturbances showed some characteristics of a deep dyslexia. Besides severely impaired reading and writing abilities, some components of Gerstamnn's syndrome were also present. Infarction in the posterior half of the left supramarginal and in the anterior half of the left angular gyrus was accurately located by the graphic reconstruction of CT scans.

Anatomic basis for surgical approach to the distal segment of the posterior cerebral artery.

The distal segment of the posterior cerebral artery (PCA), which extends from the junction with the posterior communicating artery to its terminal division into the parieto-occipital and calcarine arteries, was examined in 37 brains. Three types of distal segment were distinguished. In the first type (42.9%), the terminal division was located either in the calcarine sulcus or in the quadrigeminal cistern. In the second type (41.4%), the terminal division had the same position, but the distal segment, in addition to its terminal stems, also gave off the common temporal artery. In the third type (15.7%), the terminal division was seen in the ambient cistern. The distal segment of the PCA gave rise to several collateral branches: the collicular artery (2.8%), the anterior (28.6%), middle (30.0%), and posterior (28.6%) hippocampal arteries, the proximal (82.9%) and distal (20.0%) lateral posterior choroidal arteries, the proximal (40.0%) and distal (41.4%) medial posterior choroidal arteries, the peduncular, thalamogeniculate and splenial branches, the lingual gyri artery and the temporal arteries. Several anatomic variants of the distal segment were observed in this study: fenestration of the distal segment (1.4%), location of the distal segment dorsal to the uncus (2.8%), origin of the collicular (2.8%) and anterior choroidal arteries (1.4%) from the distal segment, and protrusion of the parieto-occipital arterial loop into the lateral ventricle (2.8%). The authors discuss the clinical significance of these anatomic data.

Size and position of the human adhaesio interthalamica.

In 50 human brains, we investigated the size of the adhaesio interthalamica, length of CA-CP line, position of the centre of adhaesio interthalamica, and the distance between the corpus callosum and adhaesio interthalamica. Interthalamic adhesion was absent in 11 brains (22%) and was duplicated in 1 brain. In all 50 brains, length of the intercommissural line (CA-CP) had a mean value of 2.56 cm, in brains with the interthalamic adhesion 2.48 cm, and 2.56 cm in brains without it. t-test for this difference showed no significant result for a probability of 0.05 (t = 1.95). Midsagittal section area of adhaesio interthalamica had a mean value of 13.1 mm2 (min = 1.5 mm2; max = 34 mm2). There is no correlation between the length of CA-CP line and the size of the midsagittal section area of adhaesio interthalamica (the correlation coefficient was 0.06). The centre of adhaesio interthalamica was most often situated above the CA-CP line and around the perpendicular line through its middle portion. The distance between the corpus callosum and interthalamic adhesion, measured in standardized system of CA-CP line, had a mean value 1.4 cm (min = 0.7 cm; max = 2.3 cm). Our results confirm the opinions that the presence of size of the interthalamic adhaesion depends not directly on the size of the corresponding brain (diencephalon).

Morphology of the human corpus callosum: the shape of its mediosagittal section.

The shape of the corpus callosum was studied on mediosagittal sections of 50 human brains. The terms "facies corticalis" and "facies profunda" are proposed for the sides of corpus callosum. Each of 50 brains had a different shape of callosal mediosagittal section and any available classification was not possible. In 94% of cases, the contour of callosal cortical surface exhibited a posterior depression and in 46% also an anterior one. Other details of callosal morphology influencing its shape on mediosagittal section (transverse folds, circumscribed depressions) were described. The junction of fornix and corpus callosum in 78% was in 3rd and in 14% in 4th quarter of callosal length. The possible significance of these findings for further studies of human brain morphology is discussed.