Value of three-dimensional volume contrast imaging C combined with magnetic resonance imaging for diagnosis of fetal cerebellar vermis and posterior cranial fossa.

OBJECTIVE: To assess the value of three-dimensional volume contrast imaging C (VCI-C) combined with magnetic resonance imaging (MRI) in the diagnosis of fetal posterior cranial cavity disease. METHODS: This study retrospectively analyzed the imaging data of 100 pregnant women with diagnosed abnormal development of fetal cerebellar vermis or posterior cranial fossa in our hospital from January 2020 to February 2022. VCI-C combined with MRI was used to evaluate the morphology of fetal cerebellar vermis, and the display of primary fissures and secondary fissures. The angle between the brain stem and cerebellar vermis (BVA) and the angle between brain stem and cerebellar tentorium (BTA) were measured and compared through MRI images. RESULTS: There was no significant difference between VCI-C and MRI in measuring the height, anteroposterior diameter, or area, BVA and BTA of fetal cerebellar vermis in the normal control group (P > 0.05). It can be considered that the two imaging methods are consistent in measuring the height, anteroposterior diameter and area, BVA, and BTA of the fetal cerebellar vermis in the normal control group. There was no significant difference between VCI-C and MRI in measuring the height, anterior posterior diameter and area, BVA, or BTA of the vermis in the group of fetal cerebellar vermis dysplasia (P > 0.05). The two imaging methods were comparable for all these measurements. CONCLUSION: Combining three-dimensional VCI-Cwith MRI diagnosis, the median sagittal section of the cerebellar vermis can be observed, the morphologic structure of the vermis, and the anatomical structure of the posterior cranial fossa can be reflected stereoscopically. Quantitative indexes can be measured and calculated to evaluate the developmental abnormalities of the fetal cerebellar vermis and the lesions of the posterior cranial fossa. Their combined effect is better than that of a single application.

A simplified cranial cavity model to understand the relationship between intracranial pressure and dural sinus pressure.

Although accurate intracranial pressure (ICP) monitoring is essential for the diagnosis and treatment of severe brain diseases, current methods are performed invasively. Therefore, a safe and less invasive ICP measurement is required. The purpose of our study was to develop a simplified cranial cavity model for a better understanding of the relationship between the ICP and the pressure measurement within the dural venous sinus (DVS) to support the validity of using sinus pressure as the surrogate of the ICP. The in-house cranial cavity model had three components: the brain part, the DVS part, and the subarachnoid space (SAS) part. Pressure in other parts was measured when the pressure in the SAS part and, separately, brain part was increased from 0 (baseline) to 50 mmHg at intervals of 10 mmHg. When the pressure in the SAS part was increased from 10 to 50 mmHg at 10 mmHg interval, pressures of both the brain and DVS parts increased without significant difference (all P > 0.05). However, pressures in both the SAS and DVS parts differed while the pressure in the brain part was increased. The pressures in both parts showed about 70% of the increase in the brain part. Nevertheless, the pressures in the SAS and DVS parts were not significantly different (P > 0.05). A simplified in-house cranial cavity model was developed consisting of three compartments to represent the actual intracranial spaces. The pressure measurement within the DVS was feasible to use as a surrogate for the ICP measurement.

Intraspecific morphological variation in myxosporeans: high pleomorphic myxospores in the same plasmodium of Myxobolus drjagini (Akhmerov, 1954).

The taxonomy of myxosporeans was traditionally dependent solely upon the spore morphological and morphometric data. Intensive reports of intraspecific morphological variation, however, are increasingly challenging the taxonomic approaches for myxosporeans. In the present work, the morphological pleomorphism of myxospores of Myxobolus drjagini (Akhmerov, 1954) was observed. More interestingly, all of these pleomorphic myxospores occurred in the same plasmodium of M. drjagini, which refutes the previous hypothesis that morphological variation of M. drjagini was derived from its responses to differences in nutrition and immunological responses associated with different host tissues. Bearing the intraspecific morphometric and morphotype variation in mind, the combination of morphological, ecological and molecular data should be applied to the species identification and delimitation for myxosporeans. This is the first reported myxobolid species with high pleomorphic myxospores which are present in the same plasmodium.

Detection of rabies virus in cranial cavity lavage of naturally infected bats.

The rabies virus (RABV) has been isolated in several bats species in the world, and among them, hematophagous, frugivorous and insectivorous species. Bats found in Brazil are small, which can lead to situations in which there are limitations in the collection of the central nervous system (CNS) and the amount of material may be insufficient to carry out laboratory diagnostic techniques for rabies. The objective of this work was to evaluate an alternative sample collection for the diagnosis of rabies in bats. A total of 92 bat samples, 82 positives and 10 negatives were selected. The cranial cavity was scraped with the aid of sterile tips and a virus diluent was added to create a suspension. All samples were submitted to Rabies Tissue Culture Infection Test (RTCIT) and reverse transcription polymerase chain reaction (RT-PCR). The diagnostic sensitivity and specificity of the RTCIT and RT-PCR using the cranial cavity lavage were calculated in comparison with the results of the laboratory routine (DFAT and RTCIT) performed with the CNS (considered gold standard). The results of the RTCIT show that the cranial cavity lavage is not an adequate sample for viral isolation, since the diagnostic sensitivity was low (37.8 %) when compared with the tests with the CNS. However, the RT-PCR of the cranial cavity lavage may be a tool to assist in the diagnosis, since it presented a sensitivity of 76.8 %. The results of this study suggest that cranial cavity lavage is an interesting alternative to enable the diagnosis of rabies in bats and increases the possibility of diagnosis contributing to rabies surveillance and control.

Effects of the cranial parasite Tylodelphys sp. on the behavior and physiology of puye Galaxias maculatus (Jenyns, 1842).

Diplostomatid digeneans are well-known manipulators of the behavior of their intermediate hosts. Unencysted metacercariae of Tylodelphys sp. inhabit the cranial cavity of the fish Galaxias maculatus; however, to date they have not been documented to alter their host behavior. The goal of this study was to evaluate the potential effects of Tylodelphys sp. inhabiting the cranial cavity of Galaxias maculatus on host physiology and swimming behavior as well as its reaction to a simulated predation attempt. Blind experiments in the lab were carried out on 56 fish that were filmed individually. The Fulton condition factor (K) was used as an approximation of nutritional status and a respirometry chamber was used to evaluate oxygen consumption rates of fish. Of the 56 fish, 21 were parasitized by Tylodelphys sp. (mean intensity = 30, range from 1 to 101). Parasitized and non-parasitized fish were similar in condition factor and oxygen consumption rates. Furthermore, the oxygen consumption rate of G. maculatus was not correlated with the abundance of Tylodelphys sp. However, parasitized fish more frequently swam close to the water surface, whereas non-parasitized fish more frequently swam at intermediate depths. When faced with a simulated predator attack, unparasitized fish showed more frequent fleeing behavior as well as a more intense post-fleeing activity. Collectively, these results suggest that Tylodelphys sp. inhabiting the cranial cavity of fish may alter their behavior predisposing them to predation by birds.

Study on the growth of intracranial volumes in normal children of different ages / 中华整形外科杂志

Objective@#The purpose of this study was to measure intracranial volumes in normal children of different ages and to explore the growth of intracranial volumes.@*Methods@#A total of 151 normal children (male, 96; female, 55) were included in this study who were subjected to computed tomography (CT) for head trauma in the pediatric emergency room from June 1, 2015 to July 31, 2015. All of them had no congenital deformities and depressed fracture of the skull. Total, anterior, middle and posterior intracranial volumes were measured using a DICOM viewer. The Graphad Prism 6.0 was applied to analyze the data and plot the best fit logarithmic growth curve and liner regression and the comparison of the growth curves between different groups was done.@*Results@#The intracranial volumes had a rapid growth within 2 years old. The girls′ total intracranial volumes were smaller than the boys′ of the same age. There was a significant difference of linear regression slope between anterior intracranial volumes and posterior intracranial volumes within 2 years old (P<0.01).@*Conclusions@#There is a rapid growth of intracranial volumes of normal children within 2 years old. The posterior intracranial volumes are expanded faster than the anterior intracranial volumes in the first two years. The girls′ intracranial volumes are smaller than the boys′.

Application of computer assisted three-dimensional simulation operation and biomechanics analysis in the treatment of sagittal craniosynostosis.

As a surgical method to treat children with sagittal craniosynostosis, calvarial vault reconstruction is subjected to some limitations. In traditional surgical method to treat children with sagittal craniosynostosis, surgical resection and fixation are performed all by the experience of surgical doctor, which is likely to cause individual differences, insecure fixation, configurational asymmetry, and waste of unnecessary fixtures materials. This study aims to provide surgical doctor with objective indicators via 3D simulation combined with biomechanical calculation, so as to improve the surgical efficiency. METHODS: The aim of this study is to compare preoperative strategy integrating computer-assisted 3D simulation and biomechanical calculation and traditional strategy. A retrospective method was used to compare the effect and difference between these 2 strategies. The clinical data of 18 patients with sagittal synostosis were collected and compared. Among them, 10 patients were enrolled in Group A applied with traditional treatment method, while 8 were enrolled in Group B applied with preoperative strategy integrating computer-assisted 3D simulation and biomechanical calculation. The aim of this study is to evaluate two treatment methods by investigating indexes between two groups, such as length of operation, blood loss, operation cost, and postoperative complications. Through comparing the cranial index, head circumference, and cranial vault asymmetry index of two groups before and after treatment, the surgical effects of two groups can be evaluated. Moreover, biomechanical analyses for two groups were conducted. RESULTS: Regarding group B, the length of operation was (217±29.3min), blood loss was (70±11.7ml), operation cost was (34,495±8662¥); while for group A, the length of operation was (276±23.5min), blood loss was (90±15.5ml), operation cost was (25,149±4133¥). No postoperative complication was observed for group B, while there was 1 case of central nervous system infection occurred in group A. The cranial indexes of both groups were significantly improved after treatment. The head circumferences of both groups were insignificantly changed after treatment. Through comparing the cranial vault asymmetry index of two groups before and after treatment, the cranial vaults of patients of group A were not so symmetrical as Group B after treatment. CONCLUSIONS: This research proposes the application of preoperative strategy integrating computer-assisted 3D technique and biomechanical analysis, which allows surgical doctors to have a clear understanding on the surgical process before operation. In particular, this new treatment method for the first time adopts biomechanical calculation to determine the setting position and setting quantity of fixtures materials, so as to realize a firm and symmetrical effect, reduce waste of unnecessary fixtures materials, increase surgical efficiency, reduce length of operation, blood loss, and occurrence of postoperative complications Computer-assisted 3D technique with biomechanical analysis is a new advanced technique for the treatment of sagittal craniosynostosis.

Tension pneumocephalus induced by high-flow nasal cannula ventilation in a neonate.

The use of high-flow nasal cannula (HFNC) therapy as respiratory support for preterm infants has increased rapidly worldwide. The evidence available for the use of HFNC is as an alternative to nasal continuous positive airway pressure (CPAP) and in particular to prevent postextubation failure. We report a case of tension pneumocephalus in a preterm infant as a complication during HFNC ventilation. Significant neurological impairment was detected and support was eventually withdrawn. Few cases of pneumocephalus as a complication of positive airway pressure have been reported in the neonatal period, and they all have been related to CPAP. This report reinforces the need to be aware of this rare but possible complication during HFNC therapy, as timely diagnosis and treatment can prevent neurological sequelae. We also stress the importance of paying close attention to flow rate, nasal cannula size and insertion, and mouth position, and of regularly checking insertion depth.

The challenge of extra-intra craniometry: a computer-assisted three-dimensional approach on the equine skull.

BACKGROUND: The topographical correlations between certain extracranial and intracranial osseous points of interest (POIs), and their age-related changes, are indispensable to know for a diagnostical or surgical access to intracranial structures; however, they are difficult to assess with conventional devices. MATERIALS AND METHODS: In this pilot study, the 3-dimensional coordinates of extra-/intracranial POIs were determined, thus avoiding perspective distortions that used to be intrinsic problems in 2-dimensional morphometry. The data sets were then analysed by creating virtual triangles. The sizes, shapes, and positions of these triangles described the extent and the directions of the age-related shifts of the POIs. A selection of extracranial and intracranial POIs were marked on half skulls of four warmblood horses in two age groups (young: 6 weeks, n = 2; old: 14 and 17 years, n = 2). The x-, y-, and z-coordinates of these POIs were determined with a measurement arm (FaroArm Fusion, FARO Europe®). Direct distances between the POIs as well as their indirect distances on the x-, y-, and z-axis, and angles were calculated. RESULTS: The analysed virtual triangles revealed that some parts of the skull grew in size, but did not change in shape/relative proportions (proportional type of growth, as displayed by POI A and POI B at the Arcus zygomaticus). The same POIs (A and B) remained in a very stable relationship to their closest intracranial POI at the Basis cranii on the longitudinal axis, however, shifted markedly in the dorso-lateral direction. In contrast, a disproportional growth of other parts of the cranium was, for example, related to POI C at the Crista nuchae, which shifted strongly in the caudal direction with age. A topographically stable reference point (so-called anchor point) at the Basis cranii was difficult to determine. CONCLUSIONS: Two candidates (one at the Synchondrosis intersphenoidalis, another one at the Synchondrosis sphenooccipitalis) were relatively stable in their positions. However, the epicentre of (neuro-)cranial growth could only be pinpointed to an area between them.

Mathematical model in post-mortem estimation of brain edema using morphometric parameters.

Current autopsy principles for evaluating the existence of brain edema are based on a macroscopic subjective assessment performed by pathologists. The gold standard is a time-consuming histological verification of the presence of the edema. By measuring the diameters of the cranial cavity, as individually determined morphometric parameters, a mathematical model for rapid evaluation of brain edema was created, based on the brain weight measured during the autopsy. A cohort study was performed on 110 subjects, divided into two groups according to the histological presence or absence of (the - deleted from the text) brain edema. In all subjects, the following measures were determined: the volume and the diameters of the cranial cavity (longitudinal and transverse distance and height), the brain volume, and the brain weight. The complex mathematical algorithm revealed a formula for the coefficient ε, which is useful to conclude whether a brain edema is present or not. The average density of non-edematous brain is 0.967 g/ml, while the average density of edematous brain is 1.148 g/ml. The resulting formula for the coefficient ε is (5.79 x longitudinal distance x transverse distance)/brain weight. Coefficient ε can be calculated using measurements of the diameters of the cranial cavity and the brain weight, performed during the autopsy. If the resulting ε is less than 0.9484, it could be stated that there is cerebral edema with a reliability of 98.5%. The method discussed in this paper aims to eliminate the burden of relying on subjective assessments when determining the presence of a brain edema.

Biometria da cabeça e da cavidade craniana de ovinos deslanados sem raça definida (Ovis aries LINNAEUS, 1758) em Petrolina/Pernambuco, Brasil / Biometry of head and cranial cavity of wooless mongrel sheep (Ovis aries LINNAEUS, 1758) in Petrolina/Pernambuco, Brazil

A espécie ovina é largamente utilizada na região Nordeste do Brasil por apresentar alta rusticidade. No entanto, sua anatomia ainda é pouco estudada. Assim, crescem os estudos para gerar subsídios técnico-científicos àqueles profissionais que trabalham com as áreas aplicadas da Medicina Veterinária e afins. O objetivo do presente estudo foi estabelecer correlações entre as dimensões da cabeça e da cavidade craniana, utilizando 80 ovinos, 40 machos e 40 fêmeas, com média de peso entre 27,0 e 33,0 kg. Em fêmeas, foi observada correlação entre a massa corpórea e o comprimento da cabeça; entre a massa corpórea e largura da cabeça; entre o comprimento da cabeça e sua respectiva largura; entre comprimento da cabeça e o comprimento da cavidade craniana e entre a altura da cabeça e o comprimento da cavidade craniana. As demais dimensões, nas fêmeas, não tiveram correlação estatisticamente significativa. Já em animais do sexo masculino, foi possível evidenciar correlação apenas entre a altura da cabeça e altura da cavidade craniana. Desta forma, é possível concluir que, quanto maiores forem as proporções da cabeça, maiores serão as dimensões e volume intracranianos.

The sheep is a commonly used species in Northeast region of Brazil because of its high rusticity. Yet, very little is known about the anatomy of these species. Therefore, the number of studies in this field is increasing to stimulate technical and scientific subsidies to professionals in Veterinary Medicine. The aim of this study was to establish correlations between the head and cranial cavity dimensions, using 80 sheep, 40 males and 40 females, with a medium weight of 27,0 to 33,0 kg. In females, it was observed correlation between corporal weight and length of the head; corporal weight and width of the head; length of the head and its respective width; length of the head and length of the cranial cavity; height of the head and length of the cranial cavity. The other dimensions, in females, had non-significant correlation. In males, the only correlation established was between height of the head and height of the cranial cavity. Thus, it was possible to conclude that the larger the proportions of the cranium are, the larger will be the dimensions and the intracranial volume.

Dimensions of the cranium and of the cranial cavity andintracranial volume in goats (Capra hircus LINNAEUS, 1758)

The aim of this project is to determine the dimensions of the cranium and the cranial cavity and the intracranialvolume in goats, using 64 adults. The dimensions of the cranium and cranial cavity were measured throughmetric tape and paquimeter, considering the intervals of the largest distances. To determine the intracranialvolume, balloons of latex were introduced in the cranial cavity, through the magnum foramen, later on, filledwith water that was transferred for graduate test tube. The average and the standard deviation of length, widthand height of the cranium, in millimeters, were respectively: 218.01 ± 6.96, 120.17 ± 10.01 and 108.14 ± 4.46.The average and the standard deviation of length, width, height, in millimeters, and of the volume of thecranial cavity, in cubic centimeters, were respectively: 109.31 ± 7.25, 61.36 ± 4.51, 63.85 ± 2.88 and119.31 ± 12.21. It was observed that, the width of the cranium possesses positive significant correlationswith the length (r = 0.6865), with the height (r = 0.5644) and with the intracranial volume (r = 0.5436).They were still established, positive significant correlations among the height of the cranial cavity, with thelength (r = 0.5682) and with the intracranial volume (r = 0.5473). Differences were evidenced between malesand females, in relation to the dimensions of the cranium and cranial cavity. There wasn’t difference of theintracranial volume in function of the sex of the goats.

Highly invasive intracranial malignant schwannoma in a rat.

A highly invasive intracranial malignant schwannoma containing several masses was detected in a 28-week-old male Crl:CD(SD) rat. Macroscopically, 3 masses were noted in the cranial cavity; one was present at the bottom of the cranial cavity and involved the trigeminal nerve, and the other two were in the parietal bone. Histologically, each mass consisted of fusiform cells with interlacing fascicular, wavy and nuclear pseudopalisading arrangements and round cells with cystic lesions. The tumor cells invaded not only the brain but also the parietal bone. In the brain, the tumor cells infiltrated diffusely into the leptomeningeal and perivascular spaces and parenchyma, in which the tumor cell morphology and invasive pattern closely resembled those of malignant astrocytoma and malignant reticulosis. Immunohistochemically, the tumor cells in the masses showed positive reactions for both S-100 protein and GFAP, while those in the cerebral invasion sites were negative for GFAP and less positive for S-100 protein. Electron microscopically, a single basal lamina layer and short intricate cell processes were confirmed in the tumor cells. From these results, the present tumor was diagnosed as a malignant schwannoma arising in the cranial cavity, probably originating from the trigeminal nerve. The present tumor is considered to be a relatively unique malignant schwannoma based on its growth and invasion patterns.