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Radiologia 2019The detection of pathological conditions related to the twelve cranial pairs represents a significant challenge for both clinicians and radiologists; imaging techniques... (Review)
Review
The detection of pathological conditions related to the twelve cranial pairs represents a significant challenge for both clinicians and radiologists; imaging techniques are fundamental for the management of many patients with these conditions. In addition to knowledge about the anatomy and pathological entities that can potentially affect the cranial pairs, the imaging evaluation of patients with possible cranial pair disorders requires specific examination protocols, acquisition techniques, and image processing. This article provides a review of the most common symptoms and syndromes related with the cranial pairs that might require imaging tests, together with a brief overview of the anatomy, the most common underlying processes, and the most appropriate imaging tests for different indications.
Topics: Cranial Nerve Diseases; Cranial Nerves; Humans; Magnetic Resonance Imaging; Symptom Assessment
PubMed: 30501996
DOI: 10.1016/j.rx.2018.09.005 -
The Journal of Manual & Manipulative... Dec 2021Neurological examination in musculoskeletal practice is a key element of safe and appropriate orthopedic clinical practice. With physiotherapists currently positioning...
BACKGROUND
Neurological examination in musculoskeletal practice is a key element of safe and appropriate orthopedic clinical practice. With physiotherapists currently positioning themselves as advanced first line practitioners, it is essential that those who treat patients who present with neck/head/orofacial pain and associated symptoms, should have an index of suspicion of cranial nerve (CN) dysfunction. They should be able to examine and determine if CN dysfunction is present, and make appropriate clinical decisions based upon those findings.
METHODS
This paper summarizes the functions, potential impairments of the nerves, associated conditions, and basic skills involved in cranial nerve examination.
RESULTS
A summary of cranial nerve examination is provided, which is based on the function of the nerves, This is intended to facilitate clinicians to feel more confident at understanding neural function/impairment, as well as performing and interpreting the examination.
CONCLUSION
This paper illustrates that CN testing can be performed quickly, efficiently and without the need for complicated or potentially unavailable equipment. An understanding of the CN's function and potential reasons for impairment is likely to increase the frequency of CN testing in orthopedic clinical practice and referral if positive findings are encountered.
Topics: Cranial Nerves; Humans
PubMed: 34182898
DOI: 10.1080/10669817.2021.1937813 -
BMC Veterinary Research May 2020Vestibular dysfunction is relatively common in dogs, with a prevalence of 0.08% reported in primary veterinary care in the UK. There are several studies investigating...
BACKGROUND
Vestibular dysfunction is relatively common in dogs, with a prevalence of 0.08% reported in primary veterinary care in the UK. There are several studies investigating how to differentiate between peripheral and central vestibular disease but only limited information regarding the possible underlying causes for peripheral vestibular dysfunction in dogs. This study therefore aimed to describe the clinical signs, magnetic resonance imaging findings (MRI), underlying causes and outcome in a large population of dogs diagnosed with peripheral vestibular disease.
RESULTS
One hundred eighty-eight patients were included in the study with a median age of 6.9 years (range 3 months to 14.6 years). Neurological abnormalities included head tilt (n = 185), ataxia (n = 123), facial paralysis (n = 103), nystagmus (n = 97), positional strabismus (n = 93) and Horner syndrome (n = 7). The most prevalent diagnosis was idiopathic vestibular disease (n = 128), followed by otitis media and/or interna (n = 49), hypothyroidism (n = 7), suspected congenital vestibular disease (n = 2), neoplasia (n = 1) and cholesteatoma (n = 1). Long-term follow-up revealed persistence of head tilt (n = 50), facial paresis (n = 41) and ataxia (n = 6) in some cases. Recurrence of clinical signs was observed in 26 dogs. Increasing age was associated with a mild increased chance of diagnosis of idiopathic vestibular syndrome rather than otitis media and/or interna (P = 0.022, OR = 0.866; CI 0.765-0.980). History of previous vestibular episodes (P = 0.017, OR = 3.533; CI 1.251-9.981) was associated with an increased likelihood of resolution of the clinical signs whilst contrast enhancement of cranial nerves VII and/or VIII on MRI (P = 0.018, OR = 0.432; CI 0.251-0.868) was associated with a decreased chance of resolution of the clinical signs.
CONCLUSIONS
Idiopathic vestibular disease is the most common cause of peripheral vestibular dysfunction in dogs and it is associated with advanced age. Incomplete recovery from peripheral vestibular disease is common, especially in dogs presenting with cranial nerve enhancement on MRI but less so if there is previous history of vestibular episodes.
Topics: Age Factors; Animals; Cranial Nerves; Dog Diseases; Dogs; Female; Labyrinthitis; Magnetic Resonance Imaging; Male; Otitis Media; Retrospective Studies; Treatment Outcome; Vestibular Diseases
PubMed: 32450859
DOI: 10.1186/s12917-020-02366-8 -
Diagnostic and Interventional Imaging Oct 2013Two different clinical entities, essential or secondary neuralgia, are associated with different pathologies. The pathways of CN V comprise the cervical spine, the... (Review)
Review
Two different clinical entities, essential or secondary neuralgia, are associated with different pathologies. The pathways of CN V comprise the cervical spine, the brainstem, the root of the nerve and the three peripheral branches: V1, V2 and V3. The lesions responsible for neuralgia are neoplastic, vascular, inflammatory, malformative or post-traumatic. The examination protocol should explore the set of CN V pathways. Neurovascular compression is the main cause of essential neuralgia. It is investigated by T2-weighted inframillimetric volume. Two conditions are necessary to diagnose a neurovascular compression: localised on the root entry zone [(REZ), 2-6mm from the emergence of the pons] and perpendicularly. In the absence of neurovascular compression, thin slices and a gadolinium injection are necessary.
Topics: Cranial Nerve Neoplasms; Diagnosis, Differential; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Nerve Compression Syndromes; Neural Pathways; Neurologic Examination; Sensitivity and Specificity; Trigeminal Nerve; Trigeminal Nerve Diseases; Trigeminal Nerve Injuries; Trigeminal Neuralgia; Trigeminal Nuclei
PubMed: 24007773
DOI: 10.1016/j.diii.2013.08.002 -
MedEdPORTAL : the Journal of Teaching... 2022Medical students often struggle with learning cranial nerve anatomy. Typically, cranial nerve anatomy is taught using didactic lectures and textbook illustrations, often...
INTRODUCTION
Medical students often struggle with learning cranial nerve anatomy. Typically, cranial nerve anatomy is taught using didactic lectures and textbook illustrations, often leaving students frustrated.
METHODS
We developed a multimodal radiologic approach to teaching cranial nerve anatomy. First, 150 students were presented with carefully curated preclass material from which to prepare. Next, they received a didactic lecture that was recorded for them to revisit on their own time. Last, students worked in groups in a lab setting with expert radiologists to identify the cranial nerves and related anatomy and learn about some basic pathophysiology. We used a pretest and posttest to examine the effectiveness of our teaching methods and a survey to measure students' satisfaction.
RESULTS
Student knowledge of cranial nerve structure was significantly improved after our module, with quiz scores increasing from 4.6 to 6.8 out of 9.0 ( < .001). In addition, students reported feeling more confident in their knowledge of the material and offered high satisfaction scores.
DISCUSSION
The breadth of knowledge covered during the preclinical training years continues to expand despite stable or even contracted durations of training, requiring knowledge to be delivered in an ever more efficient manner. Ultimately, the multimodal pedagogy used by our resource leads to students who are more confident and engaged in their learning, resulting in increased knowledge.
Topics: Cranial Nerves; Education, Medical, Undergraduate; Educational Measurement; Humans; Radiology; Students, Medical
PubMed: 35720637
DOI: 10.15766/mep_2374-8265.11261 -
Anatomical Record (Hoboken, N.J. : 2007) Mar 2019This Special Issue, entitled "Cranial Nerves: phylogeny, ontogeny, morphology and clinical significance," has been divided into two consecutive volumes. We present here... (Review)
Review
This Special Issue, entitled "Cranial Nerves: phylogeny, ontogeny, morphology and clinical significance," has been divided into two consecutive volumes. We present here the first volume, devoted to phylogeny and ontogeny. Articles in this volume examine these two topics from a microscopic point of view. This volume includes an historical review that serves as an introduction. It also includes a review of the organization of cranial nerves from a neuromeric perspective which, together with two articles in amphioxi and lampreys, give emphasis to a comparative approach. Finally, several articles examine cranial nerves zero (nervus terminalis), I (olfactory), II (optic), III, IV and VI (oculomotor), VIII (cochlear and vestibular), and XI (accessory or spinal). Together, they provide a general overview of the neuroanatomical organization of cranial nerves, while offering insights into an evo-devo paradigm. Anat Rec, 302:378-380, 2019. © 2019 Wiley Periodicals, Inc.
Topics: Biological Ontologies; Cranial Nerves; Humans; Phylogeny
PubMed: 30724480
DOI: 10.1002/ar.24072 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2019This Special Issue entitled "Cranial Nerves: phylogeny, ontogeny, morphology and clinical significance" has been divided into two consecutive volumes. This second volume...
This Special Issue entitled "Cranial Nerves: phylogeny, ontogeny, morphology and clinical significance" has been divided into two consecutive volumes. This second volume is devoted to morphology and clinical relevance. Articles in this volume examine these topics from a macroscopic point of view and with a surgical interest. This volume includes articles on oculomotor nerves III, IV, and VI and their course in the orbit; intracranial and extracranial views of the V and VII pairs; and branching patterns of IX, X, XI, and XII pairs with medical significance. Together, these articles provide a general overview of cranial nerves' gross anatomical organization, as well as improving on the knowledge necessary for clinical approaches. Anat Rec, 302:555-557, 2019. © 2019 Wiley Periodicals, Inc.
Topics: Cranial Nerves; Humans
PubMed: 30810281
DOI: 10.1002/ar.24106 -
The Kurume Medical Journal Mar 2022An ossified left petroclinoid ligament was found during routine dissection of the skull base in an adult male cadaver. The petroclinoid ligament is clinically and... (Review)
Review
An ossified left petroclinoid ligament was found during routine dissection of the skull base in an adult male cadaver. The petroclinoid ligament is clinically and surgically important given its anatomical relationships to cranial nerves III, V, and VI, so its ossification is a risk factor for injuries due to trauma, increased intracranial pressure, and vascular and tumor compression resulting in abducens and oculomotor palsies. The causes of petroclinoid ligament ossification are yet to be completely elucidated although several reports have associated them with age-related and physiological processes. Assessing the integrity of the petroclinoid ligament is important during skull base surgical interventions to avoid postoperative complications. Therefore, this paper reviews the petroclinoid ligament and its variation, the ossified petroclinoid ligament.
Topics: Abducens Nerve; Adult; Cadaver; Dissection; Humans; Ligaments; Male; Osteogenesis
PubMed: 35095019
DOI: 10.2739/kurumemedj.MS671007 -
Arquivos de Gastroenterologia Nov 2018Swallowing is a motor process with several discordances and a very difficult neurophysiological study. Maybe that is the reason for the scarcity of papers about it. (Review)
Review
BACKGROUND
Swallowing is a motor process with several discordances and a very difficult neurophysiological study. Maybe that is the reason for the scarcity of papers about it.
OBJECTIVE
It is to describe the chewing neural control and oral bolus qualification. A review the cranial nerves involved with swallowing and their relationship with the brainstem, cerebellum, base nuclei and cortex was made.
METHODS
From the reviewed literature including personal researches and new observations, a consistent and necessary revision of concepts was made, not rarely conflicting.
RESULTS AND CONCLUSION
Five different possibilities of the swallowing oral phase are described: nutritional voluntary, primary cortical, semiautomatic, subsequent gulps, and spontaneous. In relation to the neural control of the swallowing pharyngeal phase, the stimulus that triggers the pharyngeal phase is not the pharyngeal contact produced by the bolus passage, but the pharyngeal pressure distension, with or without contents. In nutritional swallowing, food and pressure are transferred, but in the primary cortical oral phase, only pressure is transferred, and the pharyngeal response is similar. The pharyngeal phase incorporates, as its functional part, the oral phase dynamics already in course. The pharyngeal phase starts by action of the pharyngeal plexus, composed of the glossopharyngeal (IX), vagus (X) and accessory (XI) nerves, with involvement of the trigeminal (V), facial (VII), glossopharyngeal (IX) and the hypoglossal (XII) nerves. The cervical plexus (C1, C2) and the hypoglossal nerve on each side form the ansa cervicalis, from where a pathway of cervical origin goes to the geniohyoid muscle, which acts in the elevation of the hyoid-laryngeal complex. We also appraise the neural control of the swallowing esophageal phase. Besides other hypotheses, we consider that it is possible that the longitudinal and circular muscular layers of the esophagus display, respectively, long-pitch and short-pitch spiral fibers. This morphology, associated with the concept of energy preservation, allows us to admit that the contraction of the longitudinal layer, by having a long-pitch spiral arrangement, would be able to widen the esophagus, diminishing the resistance to the flow, probably also by opening of the gastroesophageal transition. In this way, the circular layer, with its short-pitch spiral fibers, would propel the food downwards by sequential contraction.
Topics: Brain Stem; Cerebral Cortex; Cranial Nerves; Deglutition
PubMed: 30156597
DOI: 10.1590/S0004-2803.201800000-45 -
Eye (London, England) Feb 2015We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical... (Review)
Review
We review ocular motor cranial nerve palsies in childhood and highlight many of the features that differentiate these from their occurrence in adulthood. The clinical characteristics of cranial nerve palsies in childhood are affected by the child's impressive ability to repair and regenerate after injury. Thus, aberrant regeneration is very common after congenital III palsy; Duane syndrome, the result of early repair after congenital VI palsy, is invariably associated with retraction of the globe in adduction related to the innervation of the lateral rectus by the III nerve causing co-contraction in adduction. Clinical features that may be of concern in adulthood may not be relevant in childhood; whereas the presence of mydriasis in III palsy suggests a compressive aetiology in adults, this is not the case in children. However, the frequency of associated CNS abnormalities in III palsy and the risk of tumour in VI palsy can be indications for early neuroimaging depending on presenting features elicited through a careful history and clinical examination. The latter should include the neighbouring cranial nerves. We discuss the impact of our evolving knowledge of congenital cranial dysinnervation syndromes on this field.
Topics: Abducens Nerve; Abducens Nerve Diseases; Child; Child, Preschool; Eye Diseases; Humans; Nerve Regeneration; Oculomotor Nerve; Oculomotor Nerve Diseases; Trochlear Nerve; Trochlear Nerve Diseases
PubMed: 25572578
DOI: 10.1038/eye.2014.292