Volume changes of corpus striatum, thalamus, hippocampus and lateral ventricles in posttraumatic stress disorder (PTSD) patients suffering from headaches and without therapy.

BACKGROUND AND AIM: In the present study, we have hypothesized that volume changes of the caudate nucleus, putamen, globus pallidus, hippocampus, thalamus, and lateral ventricle in newly-diagnosed, male PTSD patients without therapy are more pronounced in those with headaches. To confirm or reject our hypothesis, we have undertaken an extensive study of forty-nine PTSD patients. PATIENTS AND METHODS: To confirm or reject our hypothesis, we have undertaken an extensive study of forty-nine PTSD male patients that underwent MRI scanning immediately upon admittance for the treatment. Based on headache frequency, they were classified into three groups: group 1 included patients with headaches at least twice a week; group 2 consisted of patients with headaches less than twice a week; and group 3 consisted of patients without headaches. All MRI scans underwent software-based volume compute and statistical processing. RESULTS: 39 out of 49 patients with PTSD suffered from headaches. Bilaterally, volume decreases were noted in groups 1 and 2 compared to group 3 for the caudate nucleus, putamen, hippocampus and lateral ventricle. Differences in globus pallidus and thalamus among groups appeared to be insignificant. CONCLUSION: The present study revealed a bilateral volume decrease of the caudate nucleus, putamen and hippocampus in PTSD male subjects without therapy. Intensity of volume alterations correlated with Hamilton's depression rating score; regression analysis uncovered correlated changes in the caudate nucleus, putamen and hippocampus, and an inverse correlation with the volume of the lateral ventricle in the PTSD patients.

[The position of anterior cuciate ligament in frontal and sagittal plane].

INTRODUCTION: Position of the anterior cruciate ligament (ACL) represents one of the anatomical factors which can lead to the rupture of the ligament. AIM: The aim of this study was to overview and compare gender and age differences of the position of the ACL and its relation with the medial aspect of the lateral femoral condyle. METHOD: The measurements were performed on the fifty cadaver knees (32 male and 18 female) aged between 15 - 53 years with intact ACL. We were measuring the angle of the ACL in sagittal and frontal plane and the angle of the medial aspect of the lateral condyle in frontal and horizontal plane. RESULTS: Measurements of the ACL in sagittal plane and measurements of the angle of the medial aspect of the lateral femoral condyle in horizontal plane showed statistically significant variations with the age (p < 0.05 and p < 0.01, respectively). The angle of the medial aspect of the lateral femoral condyle in frontal plane was statistically significant higher than the same measured angle in the horizontal plane ( p < 0.01). CONCLUSION: ACL fomis narrower angle with medial aspect of the lateral femoral condyle in extension of lower leg than in flexion as a result of smaller angle of the medial aspect of the lateral femoral condyle in frontal compared to horizontal plane.

[Correlation between femur's length and morphometric parameters of distal femur important in rupture anterior cruciate ligament].

INTRODUCTION: Frequency of anterior cruciate ligament rupture depends of anatomical parameters of distal femur and intercondylar notch. PURPOSE: Purpose of this work is identification relation between femur length and morphometrical parameters intecondylar notch, measuring in two levels. METHOD: A hundred femur's (medley population of 48 right and 52 left femurs), from osteological collection Department of Anatomy "Dr. Niko Miljanic" in Belgrade measured. Measurement was in two levels. Epicondilar width, width of medial and lateral condyls and intercondylar width, had been measured in level of popliteal sulcus and on the widest place, after that notch width index had been determinated. RESULTS: Absolute values of morphometrical parameters distal femur's are in positive relation with her length (p < 0.01), but notch width index is not, as in level of popliteal sulcus, as on the widest place (p > 0.05). CONCLUSION: Femur's length increasing also produces increasing of absolute anatomical parametars of distal femur which can produce rupture of anterior cruciate ligament, while relative dimensions do not show femur's length increasing.

[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.

[Influence of morphometric intercondylar notch parameters in ACL ruptures].

The most important anatomic risk factors in ACL lesions are the morphometric parameters of intercondylar notch. In the morphometric studies index of notch width and index of notch shape (NWI and NSI) are commonly used. The certain morphologic parameters of distal femoral part are used in calculation. Beside standard parameters we measured the maximal width of intercondylar notch and distal part of femur, which we used for calculation of maximal index of notch width and maximal index of notch shape (NWI max and NSI max). We compared two different methods of calculation of intercondylar notch indexes to find out which one represent anatomic risk factor and influence the ACL lesions. The indexes were measured in the two groups of patients (33) who have the history of knee injuries, the first group has document of ACL injuries and the second without ACL injuries (control one). The important difference between two groups was founded in NWI (p < 0.01) and NSI (p < 0.05). NWImax and NSImax do not show the difference (p > 0.05). The NWI and NSI importance is higher in males, and smaller in females. There is no difference in NWImax and NSImax (p > 0.05) comparing to the gender.

Large cava septi pellucidi in schizophrenic patients, alcoholics, head-traumatized, and normal individuals: morpholgical features and forensic implications. A postmortem study.

BACKGROUND: The enlarged cava septi pellucidi (CSP = 6 mm in length) have been reported as a reliable marker of an underlying neuropsychiatric disease or disorder. Differences in the dimensions of cava longer than 6 mm associated with a neuropsychiatric impairment could be of possible clinical and forensic significance. METHODS: We obtained 479 brains from autopsied persons (310 males and 169 females, aged 22-89 years) and observed that 110 brains (75 males and 35 females) had CSP, of which the length of CSP was equal to or longer than 6 mm on 69 (49 males and 20 females) of them. These cava were classified into four groups depending on the past medical histories of the autopsied person: five without neuropsychiatric history (asymptomatic CSP), 25 schizophrenic patients, 22 alcoholics, and 17 with a past head trauma (symptomatic CSP). RESULTS: The linear parameters of CSP (i.e. length, width) of the symptomatic and asymptomatic groups were measured and were statistically analyzed. Analysis revealed that the cava in the group of schizophrenic patients were significantly longer and wider. CONCLUSIONS: Discriminant function analysis was used to derive a mathematical formula to classify CSP into one of the groups obtained based on width measurements of the cavum.

[Important variations in the position of the ulnar nerve]. / Neke znacajne varijacije polozaja lakatnog zivca (n. ulnaris)]

The knowledge of the topographical relationship of some body structures was one of our aims in the study of the position and topography of the ulnar nerve in the lower third of the upper arm and the elbow region. The elbow region, because of its close relation to the ulnar nerve, especially the relation to the medial epicondyle of the humerus and the nerve, may explain some injuries of the nerve trunk. In this region the anterior dislocation of the ulnar nerve may occur, as well. We studied 60 specimens of the foetuses, newborn infants and adult persons of both sexes, by using macro and micro dissection. Almost in all cases (96.7%) the ulnar nerve passed from the upper arm to the forearm through the bony-fibrous opening ("the elbow tunnel") on the posterior side of the elbow. The anterior wall of the tunnel was sulcus n. ulnaris, while its posterior-medial wall was a strong, fibrous arch-shaped band that connected olecranon and the tip of the medial epicondyle. In the majority of cases (75%) this fibrous arc was thick and strong, high, and did not reach the top of the medial epicondyle. Thus it prevented the anterior dislocation of the ulnar nerve in the elbow flexion. Rarely (21.7%) this fibrous are was situated lower, even 15 mm below the medial epicondyle top. This disposition could favour the anterior dislocation of the ulnar nerve. Only rarely (3.3%) the ulnar nerve passed in front of the medial epicondyle.