The anatomy of the median branches of the basilar artery

The aim of study was the examination of the median branches (MB) of the basilar artery (BA). 783 MB were found in 100 human brainstems injected with coloured latex. The attachment of the MB to the quadrants of the BA's trunk, their structural shape, length of trunks, topographical arrangement (on three vascular levels) and the clinical importance of this vascular pattern was evaluated. The MB arise from Pr and Pl quadrants of the BA's trunk in 100% cases, represent 37.7% of BA's branches and are mostly located in the foramen caecum area (56%). The MB confine the BA's stem mobility on the V CN area and above, because of their shortest trunks especially on these vascular levels. In the examined specimens the MB varied in number from 0 to 22 (mean, 8)

Arteries to the proximal part of the olfactory tract

Destruction of the vascularisation of the olfactory structures during fronto-orbital surgical approaches to the sellar region may result in anosmia as a complication. The goal of this study was to describe the sources of blood supply to the proximal olfactory tract and the macroscopic distribution of these vessels. 20 human brains fixed in formalin with arteries injected with ink-coloured gelatine were studied using a surgical microscope and the micro-dissection technique. The vessels running along the olfactory tract posteriorly and anteriorly on its inferior and superior surface were observed. These arteries and arterioles were most often branches of the constant artery supplying the posterior part of the straight gyrus and orbital gyri (38/40). Similarly, as branches of the medial orbitofrontal artery (7/40), they were found on the superior aspect of the tract. Branches of the distal medial striate artery directed to the olfactory structures were observed on the basal surface of the tract (20/40)

The choroid plexus of the fourth ventricle and its arteries

The choroid plexus of the fourth ventricle consists of two symmetrical parts located in the roof of the ventricle and protruding through its openings, the foramina of Luschka and Magendie. The arteries supplying the choroid plexus of the fourth ventricle are difficult to approach because of their deep location within the cerebellopontine angles and the cerebellomedullary fissure. They originate from multiple sites on the cerebellar arteries, and pass near the vital structures of the pons and medulla. The increasing use of the operating microscope and endoscopy during operations in the posterior cranial fossa has created a need for better understanding of the microsurgical anatomy of the plexus and its arteries. The arteries of 15 human brain-stems with cerebelli were injected with coloured gelatine and fixed in 10% formaldehyde solution. The specimens were studied under an operating microscope. The choroids plexus on each side of the midline was divided into four segments, the medial and lateral horizontal segments and the rostral and caudal sagittal segments, in order to facilitate the description of their blood supply. The anterior inferior cerebellar artery (AICA), the posterior inferior cerebellar artery (PICA) and the superior cerebellar artery (SCA) were the main supplying vessels. AICA supplied the portion of the plexus in the cerebellopontine angles and the adjacent part of the lateral recess of the fourth ventricle through the foramina of Luschka. PICA supplied most of the choroid plexus in the roof and the median opening of the fourth ventricle

Age dependence of critical pressure in the segments and branches of the circle of Willis

Spontaneous intracranial haemorrhage is one of the most dramatic neurological disasters. The source of haemorrhage is linked to the pathology of the arterial wall or is unknown. Because the risk of haemorrhagic stroke increases with age, we tried to investigate the relationship between age and rupture pressure of cerebral arteries. In the presented study, 51 segments of large cerebral arteries (at the level of the circle of Willis and its incoming and outgoing branches) were obtained from 33 cadaver brains aged 12–86 years. The segments were pressurized up to the rupture. The rupture pressure was noted. The highest observed pressure was 4.3atm in specimen aged 24 years. The lowest pressure 1.19atm was observed in specimen aged 80 years. The mean value of rupture pressure of all investigated segments was 2.28atm. Statistical analysis showed a nonlinear exponential decrease of the rupture pressure of the large cerebral arteries with age. The main conclusion from our study is that drop of cerebral arteries strength is observed to the age of 40. Later this lowering is visible but not so evident

The importance of the superficial brachioulnar artery during surgical creation of an arteriovenous fistula for dialysis from a transposed basilic vein — potential implications for hand ischemia in case of a previously thrombosed radiocephalic arteriovenous fistula.

Podczas wytwarzania przetoki tętniczo-żylnej z przemieszczonej żyły odłokciowej znaleziono dodatkową tętnicę na przebiegu żyły odłokciowej. Pooperacyjna angiotomografia i ultrasonografia z oceną przepływu pozwoliły zidentyfikować to naczynie jako tętnicę ramienno-łokciową powierzchowną. Tętnica ta była jedyną, która zaopatrywała łuk dłoniowy, ponieważ tętnica promieniowa była niedrożna na tle zakrzepicy uprzednio wytworzonej przetoki promieniowo-odpromieniowej. Niezamierzone podwiązanie tętnicy ramienno- łokciowej powierzchownej podczas preparowania żyły odłokciowej mogłoby skutkować zatrzymaniem napływu krwi tętniczej do łuku dłoniowego i głębokim niedokrwieniem ręki u opisywanego chorego.During the surgical creation of an arteriovenous (AV) fistula from a transposed basilic vein, an aberrant artery, closely related to the course of the basilic vein, was found. A postoperative CTA, together with a Doppler sonography study, identified this artery as a superficial brachioulnar artery. The artery singularly supplied the palmar arch, as the radial artery was occluded due to thrombosis of a previously performed radio-cephalic fistula. Moreover, the unintended ligation of the superficial brachioulnar artery during preparation of the basilic vein, stopped blood flow to the palmar arch and, consequently, caused hand ischemia

How does Adamkiewicz artery influence blood supply to the fetal spinal cord?

Adamkiewicz artery became important in clinical practice since it was noticed that its damage during aorta aneurysm repair surgery can sometimes lead to distal spinal cord ischemia. The complexity of anatomical variations can be related to the development of spinal cord arteries. The aim was to describe topography of Adamkiewicz artery and its relations to the anterior spinal artery in fetuses. The study was carried on 4 Batson’s resin corrosion casts and 24 formalinfixed fetuses injected with dyed gelatin or latex aged 15-24 weeks gestational age. In fixed specimens vertebral canals were dissected, the anterior spinal artery was traced and Adamkiewicz artery localized. Arteries were photographed and digitally measured. Data were afterwards statistically analyzed. Anterior spinal artery was duplicated in 3/28 cases. There were from 1 to 3 Adamkiewicz arteries per specimen, mean 1.71. No relation was found between the number of Adamkiewicz artery and age. In 37/48 cases Adamkiewicz artery emptied into the anterior spinal artery on the left side. Mean degree of narrowing in anterior spinal artery (diameter of the anterior spinal artery above junction with Adamkiewicz artery divided by its diameter under that junction) was 76.74%. The diameter of Adamkiewicz artery was also correlated linearly with the degree of narrowing of anterior spinal artery (r=0.68; p<0.05). The arteries of the anterior aspect of thoracolumbar spinal cord in the 2nd trimester of pregnancy represent the adult pattern. A potentially great impact of Adamkiewicz artery on the distal spinal cord circulation may be postulated on the basis of these morphological data

Współzależności między wadami wrodzonymi serca a jego rozwojem w świetle współczesnych badań naukowych

This work presents current ideas on embryonic heart development and is an attempt to elucidate pathogenesis of congenital heart defects. The heart develops from 2 areas, the so-called “heart fields”, which differ in the expression of various genes and in sensitivity to certain substances (for example retinoid acid). Heart fields are the source of cardiomyocytes and endocardial endothelial cells for the developing heart tube. Neural crest cells attaining the heart take part in the formation of tunica media of great vessels and the aorto-pulmonary septum. An interaction between the cells of the secondary heart field and neural crest cells migrating to the heart plays a significant role in heart development. This interaction is accomplished by various mediators released into the cell environment (e.g. activation of Notch, which induces secretion of growth factors such as Fgf8). Disturbances in signaling between these cellular populations lead to malformations of the cardiac outflow tract. The sinus venosus is the source of endothelial cells of the coronary vasculature, whereas the proepicardium provides cells for the epicardium, smooth muscle cells and fibroblasts. Kardiol Pol 2010; 68, supl. V: 418-427W pracy przedstawiono współczesne poglądy na temat rozwoju serca oraz podjęto próbę wyjaśnienia patogenezy wad wrodzonych na podstawie aktualnego stanu badań. Serce rozwija się z 2 obszarów, pól sercotwórczych, które różnią się ekspresją genów oraz charakteryzują się odmienną wrażliwością na niektóre substancje (np. kwas retinowy). Pola sercotwórcze dostarczają kardiomiocytów oraz komórek wsierdzia dla rozwijającej się cewy serca. Komórki grzebienia nerwowego docierające do serca biorą udział w budowie błony środkowej wielkich naczyń oraz przegrody aortalno-płucnej. Ważną rolę w rozwoju serca odgrywa oddziaływanie między komórkami wtórnego pola sercotwórczego a komórkami grzebienia nerwowego migrującymi do serca. Oddziaływanie to odbywa się za pomocą różnych substancji mediatorowych wydzielanych do otoczenia (m.in. aktywacji Notch, która wyzwala czynniki wzrostu, np. Fgf8). Zaburzenia przenoszenia sygnałów między tymi populacjami komórek prowadzą do powstania wad stożka i pnia tętniczego serca. Źródłem komórek śródbłonka naczyń wieńcowych jest zatoka żylna, natomiast przednasierdzie dostarcza komórek do budowy nasierdzia, miocytów gładkich i fibroblastów. Kardiol Pol 2010; 68, supl. V: 418-42

A fully capable pianist with a congenital bilateral agenesis of extensor pollicis brevis muscle

A 28-year-old male musical student has been presented with visible inability of active abduction and extension of the thumbs in both hands beyond the neutral position. The student has not been previously diagnosed and claimed no history of trauma or surgical procedures in the area of hands and no family history of such disabilities. The student remained capable of playing on keyboard instruments on high level due to compensation by hyperextension of the interphalangeal joint of both thumbs and showed no increased frequency of the injuries or playing-related disorders. The ultrasound and MRI imaging showed complete bilateral agenesis of Extensor Pollicis Brevis muscles and was classified as isolated Congenital Clasped Thumb Syndrome. Due to the age of the student and the agenesis of the muscles the conservative treatment was deemed inadequate and due to high functionality of the student as a musician and unforeseeable results it might have on a musician’s career, surgical treatment has been disadvised