Folia Morphol
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Anatomical variations of the transverse cervical and suprascapular arteries are common. We report an adult male cadaver found to harbour an unusual variation of the right course of these two arteries. ⋯ Simultaneously, the ipsilateral suprascapular artery arose from the third segment of the subclavian artery and travelled posteriorly with the suprascapular nerve deep to the suprascapular ligament. We believe this is the first report of such a simultaneous occurrence.
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Important structures involved in the pathogenesis of occipital headache include the aponeurotic attachments of the trapezius and semispinalis capitis muscles to the occipital bone. The greater occipital nerve (GON) can become entrapped as it passes through these aponeuroses, causing symptoms of occipital neuralgia. The aim of this study was to identify topographic landmarks for accurate identification of GON, which might facilitate its anaesthetic blockade. ⋯ The location of GON for anaesthesia or any other neurosurgical procedure has been established as one thumb's breadth lateral to the external occipital protuberance (2 cm laterally) and approximately at the base of the thumb nail (2 cm inferior). This is the first study proposing the use of landmarks in relation to anthropometric measurements. On the basis of these observations we propose a target zone for local anaesthetic injection that is based on easily identifiable landmarks and suggest that injection at this target point could be of benefit in the relief of occipital neuralgia.
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The rat is the most frequently used animal in scientific inquiry conducted for the purpose of advancing basic knowledge that may lead to an improvement in the results of treatment. Understanding of the pharmacological properties of inhalation anaesthetics, in combination with monitoring of their concentration in the inspired and end-tidal gas, together provide safe and precise control of the depth of the anaesthesia. However, accurate application of the inhalation method of anaesthesia requires special equipment for the delivery and effective scavenging of inhalation anaesthetics.
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Folds of the meningeal layer of the dura mater, the falx cerebri and tentorium cerebelli, traverse the vertebrate intracranial cavity and thus compartmentalise the brain. The falx cerebelli, another dural fold, is found in the posterior cranial fossa and attaches to the inferior aspect of the tentorium cerebelli and to the internal occipital crest. We present a case of a duplicated falx cerebelli, occipital venous sinus and internal occipital crest that was detected upon routine dissection of a male cadaver. Since haemorrhage of a dural venous sinus can be a fatal complication of posterior cranial fossa surgery, knowledge of venous sinus variations in this region may prevent unpredictable complications during intracranial procedures.
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Case Reports
Bilateral accessory middle cerebral arteries associated with an aneurysm of the anterior circulation.
An accessory middle cerebral artery is one variation of the intracranial vasculature that may be a source of misinterpretation by clinicians dealing with cerebrovascular diseases. We report a case of an elderly female found to have bilateral accessory middle cerebral arteries, who presented with the rupture of an aneurysm of the anterior part of the circle of Willis. ⋯ We believe this to be the first report of bilateral accessory middle cerebral arteries associated with an aneurysm of the anterior cerebral-anterior communicating arteries. The anatomical and clinical relevance of this variation is described.