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Current Pediatric Reviews 2020To review and present the current knowledge of incidence, signs and symptoms, diagnosis and treatment of the occipital encephalocele. (Review)
Review
AIMS
To review and present the current knowledge of incidence, signs and symptoms, diagnosis and treatment of the occipital encephalocele.
BACKGROUND
Encephalocele (E) is a defect of the neural tube that refers to congenital malformations featured by skull defect and dura with extracranial spread of intracranial structures. Occipital encephalocele (OE) are the most common form of this congenital disorder and are manifested as a swelling of different sizes over the occipital bone in the midline. Proper diagnosis and treatment is highly important in the management of this congenital malformation of brain.
OBJECTIVE
To review and present the current knowledge of incidence, signs and symptoms, diagnosis and treatment of the occipital encephalocele.
METHODS
We conducted a search of case reports or case-series of patients by the use of electronic databases: Pub Med, Medline, Index Medicus, Scorpus. The key words were: encephalocele, occipital encephalocele, neural tube defect, congenital malformation. The search was updated to December 31, 2018. Papers published in English were the only source of information.
RESULTS
Occipital encephalocelle are more frequent in females than in males. The incidence is between 1 in 3000 to 1 in 10,000 live births; approximately 90% of them involve the midline. Magnetic resonance imaging is the method of choice in diagnosis and surgery is the best option for the treatment of OE. Overall morbidity and mortality is still high in spite of advenced surgical management, but have been significantly improved in recent years thanks to sophisticated highresolution imaging, adequate and proper surgical treatment and decent post-operative care.
CONCLUSION
Occipital encephalocele is the most common form of encephalocele. The diagnosis is mostly based by the use of neuroimaging techniques. Operation is the best option for treatment. Overall morbidity and mortality is still high, but have been significantly improved in recent years thanks to sophisticated high-resolution imaging, adequate and proper surgical treatment and decent post-operative care.
Topics: Encephalocele; Humans; Incidence; Neuroimaging; Neurosurgical Procedures; Occipital Bone; Prognosis
PubMed: 31656152
DOI: 10.2174/1573396315666191018161535 -
Child's Nervous System : ChNS :... Nov 2022The foramen magnum (FM) presents various alterations in craniosynostoses, such as brachycephaly or Crouzon syndrome. However, to date, no study has been devoted to its...
PURPOSE
The foramen magnum (FM) presents various alterations in craniosynostoses, such as brachycephaly or Crouzon syndrome. However, to date, no study has been devoted to its morphology and morphometry in scaphocephaly, which is the most common of cranial deformities resulting from premature fusion of cranial sutures.
METHODS
We assessed the morphology and morphometry of FM using preoperative thin-cut CT scans of 107 children with non-syndromic sagittal craniosynostosis aged 1-12 months (mean age 5.38 months). A series of sagittal and transverse dimensions were taken and the FM area was calculated in each case. Obtained data were compared to the age-matched control group of 101 normocephalic children.
RESULTS
Dolichotrematous type of FM was dominant in the scaphocephaly group and observed in 63/107 cases (58.9%). The mean FM area in the scaphocephaly group was 519.64 mm and was significantly smaller compared to the control group (p = 0.0011). The transverse diameter and anterior sagittal diameter were also significantly smaller (p = 0.0112 and p = 0.0003, respectively).
CONCLUSION
The area of FM in scaphocephaly is smaller compared to normal individuals. This is associated with a significant reduction of the width of FM in children with sagittal craniosynostosis. FM in scaphocephaly is larger than in other reported series of children with brachycephaly or Crouzon syndrome.
Topics: Child; Humans; Infant; Foramen Magnum; Craniosynostoses; Craniofacial Dysostosis; Cranial Sutures; Tomography, X-Ray Computed; Skull
PubMed: 35931858
DOI: 10.1007/s00381-022-05624-2 -
Acta Orthopaedica Et Traumatologica... Dec 2016The aim of this study was to create a map of the occipital bone using a cadaveric morphometric analysis.
OBJECTIVE
The aim of this study was to create a map of the occipital bone using a cadaveric morphometric analysis.
MATERIAL
Twelve heads, from seven male and five female cadavers, were studied. The thickness of the occipital bone was measured with a digital vernier caliper within a coordinate system.
RESULTS
The maximum thickness of the occipital bone could be measured at the external occipital protuberance (mean 15.4 mm; range 9-29.3 mm). All male individuals had higher bone thickness around this point. Further lateral a steady decrease of bone thickness could be observed. Same could be observed in craniocaudal direction. However, values above the superior nuchal line were on average thicker than below.
CONCLUSION
The measurements demonstrated a great individual variability of bone thickness of the occipital bone. The results emphasize the role of preoperative planning for the feasibility of placement of an occipital screw.
Topics: Cadaver; Female; Humans; Male; Occipital Bone; Sex Factors
PubMed: 27919561
DOI: 10.1016/j.aott.2016.04.003 -
Journal of Radiology Case Reports Aug 2013Craniocervical bony pneumatization is a rare finding, with limited numbers of cases reported in the literature. It is thought to be linked to Eustachian tube dysfunction...
Craniocervical bony pneumatization is a rare finding, with limited numbers of cases reported in the literature. It is thought to be linked to Eustachian tube dysfunction and a ball valve mechanism, and has a link with recurrent Valsalva maneuvers. We report a case of pneumatization of the occiput, atlas (C1) and axis (C2) in a patient with extensive ENT (Ear, Nose and Throat) surgical history who presented following a fall. Plain film, CT and MRI images are presented.
Topics: Cervical Atlas; Emphysema; Humans; Incidental Findings; Male; Middle Aged; Occipital Bone; Rare Diseases; Spinal Diseases; Tomography, X-Ray Computed
PubMed: 24421950
DOI: 10.3941/jrcr.v7i8.1444 -
Journal of Orthopaedic Research :... Aug 2022This study aimed at quantifying trabecular volumetric bone mineral density (vBMD) at the external occipital protuberance (EOP) and the upper cervical spine. A...
This study aimed at quantifying trabecular volumetric bone mineral density (vBMD) at the external occipital protuberance (EOP) and the upper cervical spine. A retrospective review of patients who underwent non-contrast enhanced computed tomography of the cervical spine that included the occipital bone up to the EOP between 2007 and 2020 was conducted. Measurements of trabecular vBMD were performed in the occipital midline area, with the region of interest extending 4.5 mm above and below the center of the EOP, as well as the C1 lateral masses and the C2 vertebral body using asynchronous quantitative computed tomography. Eighty-six patients (female, 37.2%) were included for analysis. The patient population was 81.4% Caucasian with a mean ± SD age of 62.3 ± 13.1 years. Total bone thickness at the EOP was 16.7 ± 3.4 mm, with a ratio of trabecular to total bone thickness of 0.44. Trabecular vBMD (mean ± SD) was significantly higher at the EOP than at C1 and C2 (EOP = 612.3 ± 145.8 mg/cm , C1 average = 290.3 ± 66.5 mg/cm , C2 = 305.8 ± 78.8 mg/cm ; p < 0.001). A significant strong correlation between trabecular vBMD of C1 and C2 was observed (r = 0.744; p < 0.001), but only low correlations between the EOP and C1 (r = 0.295; p = 0.008) and C2 (r = 0.413; p < 0.001). In individuals > 65 years of age, cervical vBMD was significantly lower, but remained high at the EOP. Clinical significance: Trabecular vBMD at the EOP is significantly higher than at the upper cervical vertebrae and remains high in older populations. Together with morphological information about the occipital bone, these results might be helpful for occipitocervical fixation when deciding about uni- or bicortical screw placement at the EOP.
Topics: Aged; Bone Density; Bone Screws; Cervical Vertebrae; Female; Humans; Middle Aged; Occipital Bone; Tomography, X-Ray Computed
PubMed: 34862648
DOI: 10.1002/jor.25224 -
Journal of Neurology, Neurosurgery, and... Feb 1955
Topics: Occipital Bone; Platybasia
PubMed: 14368325
DOI: 10.1136/jnnp.18.1.58 -
Proceedings of the Royal Society of... Dec 1946
Topics: Arteries; Arteritis; Giant Cell Arteritis; Humans; Inflammation; Occipital Bone; Temporal Arteries
PubMed: 19993455
DOI: No ID Found -
Anatomical Record (Hoboken, N.J. : 2007) Nov 2022The basioccipital bone is an essential developmental component to the occipital bone, occipital condyles, foramen magnum, clivus, and cranial base. The basioccipital...
The basioccipital bone is an essential developmental component to the occipital bone, occipital condyles, foramen magnum, clivus, and cranial base. The basioccipital bone joins each exoccipital bone with a basiexoccipital synchondrosis and the basisphenoid/sphenoid bone with a spheno-occipital synchondrosis. The basioccipital is found intermediate to the petrous temporal bones and forms the bilateral petrooccipital/petroclival fissures otherwise known as the petrooccipital complex. Thus, the basioccipital bone is a central component to the developing cranial base. Despite the importance of basioccipital development in cranial ontogeny, there has been limited study of basioccipital ontogeny. This study assessed 98 disarticulated human basioccipital bones from a perinatal population ranging in age-at-death from 5-months intrauterine to 5-months post-natal development. Size and shape of basioccipital bones were assessed with traditional and extended eigenshape geometric morphometric analysis. The results of this study demonstrate that the basioccipital bone grows in width at a faster rate than it grows in length. The maximum basioccipital width surpassed the midsagittal length at approximately 7-months intrauterine development. Canonical variate analysis revealed statistically significant shape change occurring from a relatively narrow/elongate (anterior-to-posterior) basiocciput shape with mild concavity at the foramen magnum in the fifth and sixth intrauterine months to a relatively broad/stout basiocciput shape with more pronounced concavity in the postnatal months. Likewise, growth rate in total length was greater than midsagittal length, demonstrating enlargement of concavity in the anterior foramen magnum over time. This report provides insight into cranial development and aids in estimating age-at-death among fetuses and infants.
Topics: Female; Fetus; Humans; Infant; Infant, Newborn; Occipital Bone; Pregnancy; Skull Base; Sphenoid Bone
PubMed: 34825511
DOI: 10.1002/ar.24838 -
Folia Morphologica 2021Computed tomography (CT)-based quantitative analysis of primary ossification centres in the cranium has not been carried out to date due to the limited availability of...
BACKGROUND
Computed tomography (CT)-based quantitative analysis of primary ossification centres in the cranium has not been carried out to date due to the limited availability of the foetal human material. Detailed morphometric data about the development of primary ossification centres in human foetuses may be useful in the early detection of developmental defects. Understanding the growth and development of the occipital bone is crucial in assessing the normal and pathological development of the cranial base, and the cranium as a whole.
MATERIALS AND METHODS
The study material comprised 37 human foetuses (16 males and 21 females) aged 18-30 weeks of gestation. Using CT, digital image analysis software, three-dimensional reconstruction and statistical methods, the size of the primary ossification centres of the lateral and basilar parts of the occipital bone was evaluated.
RESULTS
The morphometric characteristics of primary ossification centres of the lateral and basilar parts of the occipital bone display neither sex nor laterality differences. These ossification centres grow linearly with respect to their sagittal and transverse diameters, projection surface area and volume.
CONCLUSIONS
The obtained morphometric data of primary ossification centres in the lateral and basilar parts of the occipital bone may be considered as normative for their respective prenatal weeks and may contribute to the estimation of gestational ages and the diagnostics of congenital defects.
Topics: Female; Fetal Development; Fetus; Gestational Age; Humans; Male; Occipital Bone; Osteogenesis; Pregnancy
PubMed: 34750804
DOI: 10.5603/FM.a2021.0115 -
Biological Reviews of the Cambridge... Jun 2020The origin and evolution of the vertebrate skull have been topics of intense study for more than two centuries. Whereas early theories of skull origin, such as the... (Review)
Review
The origin and evolution of the vertebrate skull have been topics of intense study for more than two centuries. Whereas early theories of skull origin, such as the influential vertebral theory, have been largely refuted with respect to the anterior (pre-otic) region of the skull, the posterior (post-otic) region is known to be derived from the anteriormost paraxial segments, i.e. the somites. Here we review the morphology and development of the occiput in both living and extinct tetrapods, taking into account revised knowledge of skull development by augmenting historical accounts with recent data. When occipital composition is evaluated relative to its position along the neural axis, and specifically to the hypoglossal nerve complex, much of the apparent interspecific variation in the location of the skull-neck boundary stabilizes in a phylogenetically informative way. Based on this criterion, three distinct conditions are identified in (i) frogs, (ii) salamanders and caecilians, and (iii) amniotes. The position of the posteriormost occipital segment relative to the hypoglossal nerve is key to understanding the evolution of the posterior limit of the skull. By using cranial foramina as osteological proxies of the hypoglossal nerve, a survey of fossil taxa reveals the amniote condition to be present at the base of Tetrapoda. This result challenges traditional theories of cranial evolution, which posit translocation of the occiput to a more posterior location in amniotes relative to lissamphibians (frogs, salamanders, caecilians), and instead supports the largely overlooked hypothesis that the reduced occiput in lissamphibians is secondarily derived. Recent advances in our understanding of the genetic basis of axial patterning and its regulation in amniotes support the hypothesis that the lissamphibian occipital form may have arisen as the product of a homeotic shift in segment fate from an amniote-like condition.
Topics: Animals; Anura; Biological Evolution; Birds; Cervical Vertebrae; Extinction, Biological; Fossils; Hypoglossal Nerve; Mammals; Neck; Occipital Bone; Phylogeny; Reptiles; Skull; Spinal Canal; Urodela; Vertebrates
PubMed: 31912655
DOI: 10.1111/brv.12578