Surgical and radiologic anatomy : SRA
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Congenital absence of the portal vein with systemic diversion of mesenteric blood is extremely rare. We report a case of a congenital absence of the portal vein, accidentally discovered in a 59-year-old man, completely asymptomatic and not associated with other malformations or biochemical disorders. Ultrasonography imaging showed the absence of the portal vein and the distal tract of superior mesenteric and splenic veins draining together into a dilated left renal vein. Computed tomography and magnetic resonance confirmed the presence of a congenital portosystemic venous shunt and also revealed two hepatic arteries: one arising from the celiac trunk and the other from the superior mesenteric artery.
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Thiel's embalming technique, first described by Thiel in 1992, conserves texture and colour in cadavers close to that observed in the living. It would appear that few anatomy laboratories use this method, and literature describing its use worldwide is sparse. The aim of our study was to conduct a worldwide survey on the use of this method. ⋯ Thiel's embalming technique is not widely known, and therefore, little used. The main obstacle to its wider use is likely the language barrier, since most of the publications describing Thiel's method are in German, which is not widely spoken outside of a few European countries.
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The aim of this study was to document the anatomical landmarks of the motor entry point (MEP) and the intramuscular motor point (IMP) of the sternocleidomastoid (SCM) muscle for effective botulinum toxin injections. ⋯ In clinical practice, the mass in patients with torticollis or cervical dystonia might be formed at the lower part or upper part of the SCM muscle. For a mass in the upper portion of the SCM muscle, the injection area using alcohol, phenol or botulinum toxin was determined to be 20-40%. However, to inject the area at 20-40%, ultrasound guidance is recommended because of the cervical cutaneous nerves and veins. For a mass in the lower portion of the SCM muscle, the injection area of botulinum toxin was 50-70%. These areas can be used with botulinum toxin injections or other agents for motor point blocking in patients with torticollis or cervical dystonia.
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Comparative Study
Arachnoid granulations of middle cranial fossa: a population study between cadaveric dissection and in vivo computed tomography examination.
Although arachnoid granulations (AGs) were initially described by Pacchioni more than 300 years ago, they are still poorly described, especially those in middle cranial fossa. The aim of this study was to identify anatomical features of AGs in middle cranial fossa of cadaver and compare such features with that of 64-slice computed tomography. ⋯ The study provides a detailed description of AGs in or near the middle meningeal sinus, sphenoparietal sinus, lateral foramen rotundum, and cavernous sinus. It also reveals a difference in the ability of detecting cranial AGs between microanatomy and CT scans.
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Identification of the second dorsal sacral foramen (S2F) by sonographic imaging is a possible first step in localising the branches of the dorsal sacral rami. The aim of this investigation is to develop an imaging approach to assist the rapid identification of S2F using a well-known regional landmark, the posterior superior iliac spine (PSIS). ⋯ S2F has a mean maximum width of 0.76 cm and lies approximately 2-3 cm from the PSIS, 45° inferior to the horizontal. The medial left and right borders of S2F are approximately 3 cm apart. The upper three ipsilateral dorsal sacral foramina are 1-1.5 cm apart. These measurements may be useful for sonographers imaging the dorsal sacral region and eventually, for the potential identification of neurovascular branches of the dorsal sacral rami.