Surgical and radiologic anatomy : SRA
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Controlled Clinical Trial
White matter damage of patients with Alzheimer's disease correlated with the decreased cognitive function.
Increasing evidence demonstrates that there is marked damage and dysfunction in the white matter in Alzheimer's disease (AD). The present study investigates the nature of white matter damage of patients with Alzheimer's disease with diffusion tensor magnetic resonance imaging (DTI) and analyses the relationship between the white matter damage and the cognition function. DTI, as well as T1 fluid attenuated inversion recovery (FLAIR) and T2-FLAIR, was performed on probable patients of Alzheimer's disease, and sex and age matched healthy volunteers to measure the fractional anisotropy (FA) and mean diffusivity (MD) in the genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, and the white matter of frontal, temporal, parietal, and occipital lobes. ⋯ The most prominent alteration of FA and MD was in the splenium of corpus callosum. Our results suggested that white matter of patients with Alzheimer's disease was selectively impaired and the extent of damage had a strong correlation with the cognitive function, and that selective impairment reflected the cortico-cortical and cortico-subcortical disconnections in the pathomechanism of Alzheimer's disease. The values of FA and MD in white matter, especially in the splenium of corpus callosum in AD patients, might be a more appropriate surrogate marker for monitoring the disease progression.
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We searched for the surgically risky anatomic variations of sphenoid sinus and aimed to compare axial and coronal tomography in detection of these variations. Fifty-six paranasal tomography images (112 sides) were evaluated for coronal, axial and both coronal and axial images. Tomographic findings including bony septum extending to optic canal or internal carotid artery; protrusions and dehiscences of the walls of internal carotid artery, optic nerve, maxillary nerve and vidian nerve; extreme medial course of internal carotid artery; patterns of aeration of the anterior clinoid process; and Onodi cells were evaluated. ⋯ In cadaveric dissections, the septa were inserted into the bony covering of the carotid arteries in two sinuses (8.3%). Detailed preoperative analysis of the anatomy of the sphenoid sinus and its boundaries is crucial in facilitating entry to the pituitary fossa and reducing intraoperative complications. Coronal tomography more successfully detects the sphenoid sinus anatomic variations.
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The aim of this study was to describe the detailed anatomical arrangement of ligaments of the tibiofibular syndesmosis and to highlight the clinical aspects of fracture dislocations. This study was performed on 42 legs of adult human embalmed cadavers. Tibiofibular syndesmosis ligaments attachments and their mutual relationships were described and their dimensions were measured. ⋯ The length of this cartilage was variable. Some of synovial plicas from the ankle joints synovial membrane were observed at this view. We conclude that the results of this study may be useful to both orthopedic surgeons and radiologists for anatomic evaluation of the tibiofibular syndesmosis area.
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The most widely accepted description of venous anatomy in the transverse foramen involves the presence of one or two veins running along and parallel to the external side of the vertebral artery. For most surgeons, the vertebral artery is surrounded by a rete of veins which is continous with the wide sinusoids which surround the thecal sac (internal vertebral venous plexus). The goal of this study was to ascertain the exact structure of the venous system in the transverse canal by micro dissection and histology. ⋯ There was no evidence of a vein inside the transverse canal. The periosteum spans the space between the transverse processes and gives off fibrous leaflets to the artery thus forming a compartmentalized space lined with vascular endothelium around the artery. The venous system in the transverse canal presents itself as a sinus similar to the intracranial sinus structure.
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An understanding of the microsurgical anatomy of the arachnoid membranes and the subarachnoid cisterns is important in minimally invasive neurosurgery. But the topography of the arachnoid membranes has not been completely elucidated. The description of the distribution and the configuration of the intracranial arachnoid membranes is still a subject of controversy. ⋯ Almost all the cranial nerves were encased by their own arachnoidal sheaths when they crossed the cisterns. The arachnoid membranes and trabeculae must be dissected or incised sharply during the operations. Thorough knowledge of the anatomy of the intracranial arachnoid membranes is valuable to take full advantage of the natural anatomic landmarks and interfaces formed by them during surgery.