Microsurgical Anatomy of Periventricular White Matter from the Endoventricular Perspective.

Understanding the spatial disposition of fiber bundles is a requisite for efficient operative planning in cerebral surgery, respecting the most eloquent structures even when not seen by the naked eye. In this study, we used fiber dissection to show critical relationships between the lateral ventricles and white matter fasciculi. Twenty cerebral hemispheres obtained from body donation were used to study the lateral ventricles, white matter tracts, and their anatomic relationships. We used a variant of the method described by Ludwig and Klingler for fiber dissection, from inside the ventricular cavity after removing the ependyma. After removing the ventricular ependyma, adjacent structures were exposed. Corpus callosum fibers form the roof of the lateral ventricle, as well as the anterior wall and floor of the frontal horn. The tapetum, optic radiations, and association fasciculi dominate in the atrium and occipital horn, with distinct fiber orientation patterns. The medial wall of the occipital horn is marked by the presence of the major forceps fibers underneath the bulb of the corpus callosum. The temporal horn walls are characterized by multiple elements, including the hippocampus medially, tapetum fibers laterally and posteriorly, and key neighboring bundles, such as the optic radiations superiorly and the inferior longitudinal fasciculus inferiorly. Fiber dissection through ependyma removal is an effective method for studying anatomic relationships with adjacent white matter bundles, important for developing a precise anatomic mental picture necessary for effective and safe brain surgery

Central Nervous System Siderosis Associated with Multiple Cerebral Aneurysms: Literature Review and Description of an Additional Case

Background: Superficial siderosis (SS) of the central nervous system is a rare disease characterized by deposition of hemosiderin along the leptomeninges due to chronic or recurrent bleeding into the subarachnoid space. The association of unruptured intracranial aneurysm (IA) and cortical SS is quite rare. Methods: A systematic literature review to assess possible commonalities and/or differences of previous reported cases was undertaken. We report an additional case from our institution. Results: A 40-year-old woman presented with a history of generalized seizures over the past year. There was no clinical history suggestive of aneurysm rupture. Magnetic resonance imaging revealed 2 aneurysms of the right middle cerebral artery (MCA) bifurcation associated with hemosiderin deposition along the right sylvian fissure and a third aneurysm of the left MCA bifurcation. Magnetic resonance imaging showed wall enhancing thickening of the larger right MCA aneurysm. The patient underwent surgical clipping of all 3 MCA aneurysms in a staged procedure. Histological examination revealed hemosiderin deposits within the aneurysm wall and surrounding gliosis. Conclusions: Our literature review found 24 reported cases of unruptured IA associated with cortical SS. The possible source for leakages could be neovessels visible in IA walls. The case reported illustrates an uncommon presentation of recurrent bleeding from an IA as a source of SS. The presence of an apparently unruptured IA surrounded by cortical SS on imaging studies is of high relevance as this should be considered a sign of aneurysm wall instability and should indicate prompt treatment

How 'universal' is the United Nations' Universal Periodic Review process? An examination of the discussions held on polygamy

In 2006, United Nations Human Rights Council was tasked to establish a new human rights monitoring mechanism: Universal Periodic Review process. The primary aim of this process is to promote and protect the universality of all human rights issues and concerns via a dialogical peer review process. The aim of this investigation isto ask the following question: has this claim of promoting and protecting the universality of the human rights been met, or challenged, during state reviews in the UPR process? The issue of polygamy has been selected as the focus for this investigation to be used, primarily, as a tool to undertake an in-depth analysis of the discussions held during state reviews in the review process. In addition, this paper will employ scholarly debates between universalism and cultural relativism, as well as the sophisticated and nuanced approaches that fall in between the polarised opposites, to analyse the discussions held on human rights during state reviews. Ultimately, the findings and discussion of this investigation will provide a unique and valuable insight to the work and operation of the UPR process, so far

Health problems in children with Down syndrome

status: publishe

'Sexuality and citizenship in Europe: sociolegal and human rights perspectives' [Review] Francesca Romana Ammaturo (2017) European Sexual Citizenship: Human Rights, Bodies and Identities

In her first monograph, European Sexual Citizenship: Human Rights, Bodies and Identities, Ammaturo offers us an authoritative and fluid analysis of the intersections between citizenship, human rights and sexual minorities. The book has a strong Foucauldian flavour, exploring the ways in which power relationships are produced in this context. Ammaturo crafts a smooth flow of ideas, arguments and sources that address in a comprehensive fashion how these intersections need to be unpacked, dissected and brought to daylight for everyone’s benefit. And she does so in an accessible and ambitious way, without ever becoming simplistic or obscure – no mean feat. Ammaturo’s starting point is Europe as a continent defined as ‘an aspirational entity and symbolic space of belonging’ (p. 1, original italics). In this space, gender and sexual minorities (referred throughout the book as LGBTQI persons) arguably play a crucial role in the definition of ‘European identity’ and ‘European Citizenship’ and contribute to Europe having increasingly adopted a ‘symbolic position of catalyst for social change’ (p. 2) for these minorities. Both human rights and citizenship frameworks and discourses have contributed to these developments. Ammaturo is keen to explore the grey areas in these developments and unleash the potential for radical transformation of current constraints on the citizenship and rights of gender and sexual minorities. To do this, Ammaturo chooses the Council of Europe – and the European Court of Human Rights (Strasbourg Court) in particular – as the context in which a ‘European sexual and gendered citizenship’ can be tested and put to its limits. In doing this, Ammaturo offers particular attention to a specific group within the diverse gender and sexual minorities that exist: LGBTQI asylum seekers and refugees. In this review essay, I will explore some of the book’s key arguments and touch on some differences of opinion. Perhaps, these differences are mostly the result of different disciplinary backgrounds: while Ammaturo is fundamentally an international relations and social sciences scholar – thus perhaps more concerned with broader policy and institutional mechanisms – I am fundamentally a lawyer – thus more inclined by training to concentrate on particular policymaking areas and require strong evidence to substantiate final conclusions. This review essay will thus reflect the challenges faced by all of us academics in the field of sociolegal studies and interdisciplinary research more generally