Morphometric analysis of corpus callosum in relation to brain size in fetuses of South Indian population

Background: The corpus callosum (CC) comprises axons connecting the cortices of the two cerebral hemispheres and is the principal white matter fiber bundle in the brain Morphological characteristics of fetal corpus callosum are of value from embryologic and diagnostic points of view. Knowledge of fetal callosal size is an essential prerequisite for the study of its changes during infancy and childhood. Methods: The study included twenty four formalin fixed fetuses ranging from 25 to 40 weeks obtained from department of Anatomy, Kasturba Medical College. The measurements taken were; frontal pole to occipital pole, anterior most point to posterior most point of CC, frontal pole of brain to anterior most point of CC, occipital pole of brain to posterior most point of CC, anterior edge of splenium to superior most point of superior colliculus and thickness of body of CC.Results: Spearman’s correlation test was used to determine the correlation between different parameters. A strong positive correlation was found between the length and gestational age (r=0.69), between thickness and gestational age (r=0.4) and between length and thickness of corpus callosum (r=0.5).Conclusions: Length and thickness of corpus callosum was found to increase proportionally to gestational age but it was not statistically significant. The growth of CC was proportional to the growth of brain. The precise anatomical knowledge regarding the morphology and growth of corpus callosum will provide baseline data for the diagnosis and assessment of progression of a disease affecting it.

Correlation of placental histomorphology with doppler velocimetry in preeclampsia and IUGR and their perinatal outcome

Background: Though numerous placental ischemic changes are described in relation to placental insufficiency, universally accepted criteria are unavailable till date leading to under or over reporting. Present study is an attempt to define standardized grading system for placental dysmorphology and correlate it with Doppler changes. The objective was to study placental histomorphology in preeclampsia and IUGR (Intrauterine Growth Restriction), to correlate the placental histomorphology with multivessel Doppler findings and their perinatal outcome in preeclampsia and IUGR.Methods: Prospective study was done over 2 years, 64 antenatal women with preeclampsia and/or IUGR were recruited, their multivessel Doppler measurements were recorded and placental histomorphological changes were studied post-delivery which were graded as either low or high grade placentas considering degree and number of ischemic changes observed.Results: Out of 64 cases, 33 (51.5%) cases had low grade changes and 31 (48.5%) had high grade changes. Out of 33 patients with low grade placentas 24 (73%) had normal Doppler, 20 (65%) out of 31 high grade placenta had abnormal Doppler. Placental histomorphology correlated well with Doppler abnormality (Coefficient of Kappa test). Syncytial knots>50%, presence of hypermature villi, infarcts, fibrin deposits were significantly associated with abnormal Doppler. High grade placenta group had significantly poor perinatal outcome (Chi square test).Conclusions: We formulated a grading system of placental dysmorphology in preeclampsia and IUGR which correlated well with clinical Doppler abnormality and perinatal outcome. Further studies are warranted to develop preventive strategies aimed at specific high grade placental changes seen in pregnancies with abnormal Doppler and develop strategies to improve perinatal outcome.

An Unusual Right Popliteal Vein Aneurysm in an Adult: A Case Report

The incidence of venous aneurysm is less than arterial aneurysms. Most of them are incidental findings with no major clinical significance. However, popliteal vein aneurysms may be potentially life threatening as they can be a source of pulmonary embolism and potentially even death. We report a case of right popliteal vein aneurysm in a 67-year-old male cadaver. Information from this case study may contribute to an improved understanding of these phenomena, including early detection of these or similar thromboembolic events.

An unorthodox innervation of the gluteus maximus muscle and other associated variations: A case report

Knowledge of peripheral nerve morphology, location, and variation is important for facilitating appropriate diagnosis and intervention. We present a unique case of absence of the inferior gluteal nerve and high division of the sciatic nerve. In this instance, the common peroneal nerve was found piercing the piriformis muscle and emerging distally in the form of two trunks: thin medial and thick lateral. The medial trunk presented an interesting course, supplying the gluteus maximus muscle before joining the lateral trunk to form the common peroneal nerve. Additionally, the arteria nervi ischiadisci was also observed accompanying and supplying the tibial nerve passing inferior to the piriformis. These variations are important for clinicians and surgeons for some radiological diagnoses and surgical procedures in the lower limb

A morphometric study of arch of the great saphenous vein and its clinical significance

Objective: Varicosities in the lower limbs are the most important afflictions of the venous system, as well as of the peripheral vascular disorders. They are always caused by a fault in the valves inside the veins at the point where the superficial veins communicate with the deep veins. If the valve leaks, the blood flows backwards and this increases the pressure in the superficial veins, which, as blood stagnates, becomes swollen and varicose. The treatment of these varicose veins is surgery, for which the surgeons should have a sound knowledge of the anatomy of the great saphenous vein (GSV). So, the aim of our study was to establish palpable anatomical markers for its exploration and surgical approach. Materials and Methods: In this study, 25 inguinofemoral regions of lower limbs were dissected. After exposing the arch of the GSV, we took the following measurements using a calliper - the distance separating the top of the arch of the GSV a) from the ventral-cranial iliac spine, b) from the pubic tubercle, and c) from the inguinal ligament. Statistical analysis of the measurements was done. Results: The mean distance of the arch of the GSV from the ventral cranial iliac spine, pubic tubercle, and the inguinal ligament was 9.46 cm, 4.66 cm, and 2.75 cm respectively. In addition, we found in one case a duplication of the GSV just above the knee. Conclusion: These measurements will help the surgeons in identifying the arch of the GSV before it opens into the anterior-internal surface of the femoral vein

Horse-shoe Shaped Kidney in Fetus: A Case Report

Horseshoe kidneys are found in 3% of the population and are probably the most common of all renal fusion anomalies. This anomaly consists of two distinct renal masses lying vertically on either side of the midline and connected at their respective lower poles by a parenchymatous or fibrous isthmus. In a male fetus, aged 32 weeks of gestation, horseshoe kidney was observed during anatomical dissection. Variations in the position of the ureter and the arterial supply were also noted. Although most cases of horseshoe kidneys are asymptomatic and discovered upon autopsy, the condition may increase the risk for ureteric obstruction, venacaval obstruction due to abnormal placement of ureter, renal infections associated with vesicoureteral reflux, renal stones due to deviant orientation of kidneys combined with slow urine flow and increased risk of renal cancer. [Med-Science 2015; 4(1.000): 1818-25

Fetal and Primitive Type of Circle of Willis with Unilateral Trifurcation of Internal Carotid Artery

Circle of Willis is a network of arteries in the base of the brain between the internal carotid artery and the vertebral artery to establish the collateral circulation between these two major arteries. Anomalies in this network may lead to serious clinical conditions like stroke by impairing the vital blood circulation. Normally, the internal carotid artery communicates with the posterior cerebral artery from the basilar artery by a thin posterior communicating artery. The present case however shows a rarity where both anterior cerebral arteries were arising from the left internal carotid artery and the right anterior cerebral artery had a small communication from the right internal carotid artery. In addition, both posterior communicating arteries were large and continued as posterior cerebral arteries with small contribution from the basilar artery. The knowledge of such variations may be useful for neurosurgeons and radiologists during the diagnosis and to plan the treatment regime. [Med-Science 2014; 3(3.000): 1530-7

A morphometric study of measurements of heart in adults and its relation with age and height of the individual: A post-mortem study

Objective: Reconstructive and replacement operations of diseased cardiac valves are commonly practiced these days. It may be noted that the choice of proper reconstructive intervention and prosthetic replacement might require the normal morphometric measurements of heart in relation with general body parameters, like age and height. So, this study was undertaken to measure various measurements of heart and its relation with age and height of the individual. Materials and Methods: Sixty five normal post-mortem hearts of adults were taken from the mortuary of Department of Forensic Medicine. Age of the individual was noted. Length of the deceased was measured with a measuring tape from the level of vertex to the outer border of heel. Length (from apex to base), breadth (at broadest diameter) and thickness of the heart were measured with slide callipers. Weight was measured with weighing machine. Results: The mean length, breadth, thickness of heart in males and females are 11.25, 8.78, 3.97 cm and 10.60, 8.31, 3.63 cm. The mean weight of heart in males and females was 323 and 276 gms. There was significant correlation with weight of individual and weight of heart in males. There was significant correlation with age of individual and length of heart in females. Conclusion: This study will be helpful for cardiothoracic surgeons while doing surgery on hearts

Posterior belly of the digastric muscle: An important landmark for various head and neck surgeries

Objectives: The digastric muscle is an important landmark in head and neck surgeries. Important neurovascular structures such as the spinal accessory and hypoglossal nerves (HNs), internal jugular vein (IJV) and internal carotid artery lie deep to the posterior belly of digastric (PBD); the study relating to it deserves special mention in anatomical literature. Therefore, the present study aims to describe the PBD in relation to the essential anatomical landmarks. Materials and Methods: This study was carried out using 10 cadavers preserved in 10% formalin. The midpoint of IJV in the neck was identified as the point between the angle of the mandible and midclavicular point. The anatomical landmarks considered for measuring the parameters were tip of the mastoid process (TMP), loop of HN, midpoint of IJV, bifurcation of common carotid artery (CCA) and the midpoint of PBD. Various parameters were measured using the digital calipers. Results: The length of PBD was 3.77 +/- 1.08 cm on right and 3.15 +/- 0.05 cm on left side indicating slightly longer belly on the right. The extended length did not vary much on both the sides, which were 6.7 +/- 1.23 cm on right and 6.7 +/- 0.75 cm. The HN crossed PBD 2.72 +/- 0.8 cm anterior to the TMP on right side, while on left side it was situated 2.1 +/- 0.57 cm anterior to TMP. The distance between the midpoint of PBD and of IJV was 6.58 +/- 0.99 cm on right side, whereas it was 6.1 +/- 0.96 cm on left side. The distance between the midpoint PBD and bifurcation of CCA was 3.04 +/- 0.61 cm on right and 2.78 +/- 0.74 cm on left side. Conclusion: As the PBD muscle is an important surgical landmark, the present study adds to the existing knowledge about it. The present study has also included few newer landmarks, which were not given importance in the previous studies. [Arch Clin Exp Surg 2015; 4(2.000): 79-82