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Scientific Reports Mar 2024The lesser occipital nerve (LON) has one of the most variations among occipital nerves. We aimed to investigate morphological and morphometric features of LON. A total...
The lesser occipital nerve (LON) has one of the most variations among occipital nerves. We aimed to investigate morphological and morphometric features of LON. A total of 24 cadavers, 14 males (58%) and 10 females (42%), were dissected bilaterally. LON was classified into 3 types. The number of branches and the perpendicular distances of the point where LON emerged from the posterior border of sternocleidomastoid muscle to vertical and transverse lines passing through external occipital protuberance were determined. The shortest distance between LON and great auricular nerve (GAN), and linear distance of LON to its branching point were measured. The most common variant was Type 1 (30 sides, 62.5%), followed by Type 2 (12 sides, 25%) and Type 3 (6 sides, 12.5%), respectively. In males, Type 1 (22 sides, 78.6%) was the most common, while Type 1 (8 sides, 40%) and Type 2 (8 sides, 40%) were equally common and the most common in females. On 48 sides, 2-9 branches of LON were observed. The perpendicular distance of said point to vertical and transverse lines was meanly 63.69 ± 11.28 mm and 78.83 ± 17.21 mm, respectively. The shortest distance between LON and GAN was meanly 16.62 ± 10.59 mm. The linear distance of LON to its branching point was meanly 31.24 ± 15.95 mm. The findings reported in this paper may help clinicians in estimating the location of the nerve and/or its branches for block or decompression surgery as well as preservation of LON during related procedures.
Topics: Male; Female; Humans; Clinical Relevance; Peripheral Nerves; Occipital Bone; Neck Muscles; Cadaver
PubMed: 38462647
DOI: 10.1038/s41598-024-55648-8 -
European Spine Journal : Official... Feb 2010
Topics: Atlanto-Occipital Joint; Bone Screws; Cervical Atlas; Female; Gait Disorders, Neurologic; Humans; Internal Fixators; Joint Instability; Middle Aged; Occipital Bone; Postoperative Complications; Prosthesis Implantation; Spinal Cord Compression; Spinal Fusion; Treatment Outcome; Wounds and Injuries
PubMed: 20130929
DOI: 10.1007/s00586-010-1303-3 -
Bone May 2021Achondroplasia, the most common form of disproportionate short stature, is caused by a variant in the fibroblast growth factor receptor 3 (FGFR3) gene. Advances in drug... (Review)
Review
Achondroplasia, the most common form of disproportionate short stature, is caused by a variant in the fibroblast growth factor receptor 3 (FGFR3) gene. Advances in drug treatment for achondroplasia have underscored the need to better understand the natural history of this condition. This article provides a critical review and discussion of the natural history of achondroplasia based on current literature evidence and the perspectives of clinicians with extensive knowledge and practical experience in managing individuals with this diagnosis. This review draws evidence from recent and ongoing longitudinal natural history studies, supplemented with relevant cross-sectional studies where longitudinal research is lacking, to summarize the current knowledge on the nature, incidence, chronology, and interrelationships of achondroplasia-related comorbidities across the lifespan. When possible, data related to adults are presented separately from data specific to children and adolescents. Gaps in knowledge regarding clinical care are identified and areas for future research are recommended and discussed.
Topics: Achondroplasia; Adolescent; Adult; Child; Cross-Sectional Studies; Foramen Magnum; Humans; Longitudinal Studies
PubMed: 33545406
DOI: 10.1016/j.bone.2021.115872 -
Journal of Anatomy Nov 2016Development of somites leading to somite compartments, sclerotome, dermomyotome and myotome, has been intensely investigated. Most knowledge on somite development,...
Development of somites leading to somite compartments, sclerotome, dermomyotome and myotome, has been intensely investigated. Most knowledge on somite development, including the commonly used somite maturation stages, is based on data from somites at thoracic and lumbar levels. Potential regional differences in somite maturation dynamics have been indicated by a number of studies, but have not yet been comprehensively examined. Here, we present an overview on the developmental dynamics of somites at occipital and cervical levels in the chicken embryo. We show that in these regions, the onset of sclerotomal and myotomal compartment formation is later than at thoracolumbar levels, and is initiated simultaneously in multiple somites, which is in contrast to the serial cranial- to- caudal progression of somite maturation in the trunk. Our data suggest a variant spatiotemporal regulation of somite development in occipitocervical somites.
Topics: Animals; Cell Differentiation; Cervical Vertebrae; Chick Embryo; Embryonic Development; In Situ Hybridization; Occipital Bone; Somites
PubMed: 27380812
DOI: 10.1111/joa.12516 -
The Neuroradiology Journal Aug 2022Isolated occipital condyle lesions are commonly treated with empirical radiation, with the sole aim of relieving symptoms. Patients rarely undergo surgical biopsy,... (Review)
Review
Isolated occipital condyle lesions are commonly treated with empirical radiation, with the sole aim of relieving symptoms. Patients rarely undergo surgical biopsy, considering the morbidity associated with open surgery approaches and the importance of surrounding structures limiting the application of computed tomography (CT) scan or fluoroscopic percutaneous needle biopsies. We describe the case of a 66-year-old woman who was admitted on an emergency basis. Her clinical presentation included unilateral occipital headache and ipsilateral hypoglossal nerve palsy. Imaging revealed findings consistent with an isolated right occipital condyle lesion. In order to pursue a tissue diagnosis, essential to dictate medical management accurately, a minimally invasive biopsy of the occipital condyle through the trans-oral route was performed. Combined fluoroscopy, cone-bean CT and angiography allowed safe access to the lesion.
Topics: Aged; Biopsy; Female; Headache; Humans; Hypoglossal Nerve Diseases; Occipital Bone; Tomography, X-Ray Computed
PubMed: 34550830
DOI: 10.1177/19714009211044705 -
Anesthesiology Oct 2016
Topics: Adult; Humans; Intubation, Gastrointestinal; Male; Mandibular Fractures; Occipital Bone; Skull Fractures; Tomography, X-Ray Computed; Young Adult
PubMed: 27148919
DOI: 10.1097/ALN.0000000000001145 -
Medicine Jul 2023The synergistic effect between nonmalignant lesions can also cause a serious impact on patient survival. This disease involves different organ systems and presents with...
RATIONALE
The synergistic effect between nonmalignant lesions can also cause a serious impact on patient survival. This disease involves different organ systems and presents with a variety of clinical manifestations, such as schwannoma, depigmentation, low-grade glioma, and skeletal abnormalities. We report a case of type I neurofibromatosis with an occipital bone defect.
PATIENT CONCERNS
We report a case of a 50-year-old man with type I neurofibromatosis with occipital bone defect.
DIAGNOSIS
The patient was accepted by the local hospital due to sudden right upper limb weakness accompanied by jitter without recognizable cause or inducement. A computerized tomography scan at a local hospital suggested subcutaneous neurofibromatosis with a left occipital cranial defect with thinning bone. On admission physical examination, diffuse multiple masses could be seen throughout the body and head of different sizes and composed of soft and tough textures. The largest one was located in the posterior occipital bone, approximately 8*8 cm in size, with a child tumor and tough texture. Multiple café-au-lait spots could be found on the chest and back, and multiple freckles can be seen in the armpit. The patient underwent surgery. Postoperative pathology showed a spindle cell tumor, which was determined to be neurofibromatosis type I according to immunopathology and clinical data.
INTERVENTIONS
The patient was admitted for surgical treatment. During the operation, the scalp mass was completely abducted and the tumor tissue at the skull defect was sharply separated. Postoperative pathology showed that the peripheral margin and the bottom margin were cleaned.
OUTCOMES
Computerized tomography and magnetic resonance imaging showed that the tumor was completely. There were not any surgical complications. The patient recovered well, was cured and was dismissed from the hospital.
LESSONS
The synergistic effect between nonmalignant lesions can also cause a serious impact on patient survival to encourage early medical intervention. The clinical presentation of neurofibromatosis type I am usually nonmalignant, and in this case, involvement of the skull with bone defect is very rare. Therefore, it is necessary to accumulate relevant cases, reveal the pathogenesis of the disease, predict the development and outcome, and provide more evidence for early therapeutic intervention of similar patients in the future.
Topics: Humans; Male; Middle Aged; Cafe-au-Lait Spots; Neurofibromatoses; Neurofibromatosis 1; Occipital Bone; Tomography, X-Ray Computed
PubMed: 37478251
DOI: 10.1097/MD.0000000000034413 -
Canadian Journal of Surgery. Journal... Dec 2001To provide an overview of atlanto-occipital dislocation and associated occipital condyle fracturcs so as to alert physicians to this rare injury and potentially improve... (Review)
Review
OBJECTIVE
To provide an overview of atlanto-occipital dislocation and associated occipital condyle fracturcs so as to alert physicians to this rare injury and potentially improve patient outcome. The pertinent anatomy, mechanism of injury, clinical and radiologic evaluation and the management of these rare injuries are discussed in an attempt to alert physicians to this type of injury and to improve outcome.
DATA SOURCES
The data were obtained from a MEDLINE search of the English literature from 1966 to 1999 and the experience of 4 spine surgeons at a quaternary care acute spinal cord injury unit.
STUDY SELECTION
Detailed anatomic and epidemiologically sound radiology studies were identified and analyzed. Only small retrospective studies or case series were available in the literature.
DATA EXTRACTION
Valid anatomic, biomechanical and radiologic evaluation was extracted from studies. Clinical data came from limited studies and expert opinion.
DATA SYNTHESIS
Early diagnosis is essential and is facilitated by a detailed clinical examination and strict adherence to an imaging algorithm that includes CT and MRI scanning. When the dislocation is identified, timely gentle reduction and prompt stabilization throuigh nonoperative or operative means is found to optimize patient outcome.
CONCLUSIONS
Atlanto-occipital dislocation should be suspected in any patient involved in a high speed motor vehicle or pedestrian collision. Once suspected, proper imaging and appropriate management of these once fatal injuries can improve survival and neurologic outcome.
Topics: Atlanto-Occipital Joint; Humans; Joint Dislocations; Occipital Bone; Radiography; Skull Fractures; Survival Rate
PubMed: 11764873
DOI: No ID Found -
Orthopaedic Surgery Feb 2022To evaluate the clinical efficacy and safety of the modified technique utilizing the occipital bicortical screws and plate system in occipitocervical revision surgery.
BACKGROUND
To evaluate the clinical efficacy and safety of the modified technique utilizing the occipital bicortical screws and plate system in occipitocervical revision surgery.
METHODS
Between October 2010 and May 2018, 12 consecutive patients were retrospectively evaluated. All patients had posterior occipitocervical resurgery utilizing modified technique of bicortical screws and occipital plate. The measurements of extracranial occiput on midline were conducted on computed tomography (CT) scans. The thickness of the occipital bone at the location of external occipital protuberance and below 15 mm were evaluated, respectively. For the procedure, the trajectory was drilled perpendicular to the external occipital protuberance for the specified depth with a depth-limited drilling, 2 mm away from the internal bone plate, then the trajectory was deepened at intervals of 1 mm each time until reaching the internal bone plate. Meanwhile, a probe was used to explore all the walls of the trajectory. Bicortical screws were inserted to the occipital plate and the depth of penetration was less than 2 mm from the internal bone plate. Clinical efficacy and radiographic evaluation were followed up.
RESULTS
The thickest point was the external occipital protuberance, which was 15.49 ± 1.47 mm and decreased gradually on the midline to 13.41 ± 1.60 mm at below 15 mm. Twelve cases (mean age 41.17 years; range, 24-62 years), including five males and seven females, were followed up for 24.08 months (14-32 months). The interval time was 40.42 months (3-156 months) after the initial operation. At the final follow-up, JOA score increased from 8.58 ± 2.53 before surgery to 12.67 ± 1.84 (P < 0.05) and VAS score improved from 6.17 ± 1.21 to 2.08 ± 1.32 (P < 0.05). Besides, clinical symptoms were relieved in all patients after revision surgery. All patients had rigid internal fixations with bone fusion and no major complications occurred.
CONCLUSIONS
Posterior occipitocervical plate-screw system with bicortical screws had the advantages of safety, simple and promising efficacy without excessive tissue release or intraspinal manipulation, proving that it's valuable as a modified technique for occipitocervical revision surgery.
Topics: Adult; Bone Plates; Bone Screws; Cervical Vertebrae; Female; Humans; Male; Occipital Bone; Reoperation; Retrospective Studies; Spinal Fusion
PubMed: 34904372
DOI: 10.1111/os.13086 -
AJNR. American Journal of Neuroradiology 1981
Topics: Cranial Fossa, Posterior; Humans; Infant; Male; Meningitis; Meningocele; Occipital Bone; Radiography
PubMed: 6784543
DOI: No ID Found