Estimation of Purkinje cell quantification and volumetry in the cerebellum using a stereological technique

Systematic sampling using the Cavalier’s principle provides accurate, efficient, cheap, and simple quantitative estimates of objects within neuroanatomical structures like the cerebellum. We identified and isolated the Purkinje cell layer and used this information to extrapolate the stereological technique to estimate the total number of Purkinje cells and volume on light microscope in rabbits’ cerebella. Volumes of the cell populations in the cerebellum have not been estimated previously. Using this method, we counted the Purkinje cells in the two right and three left hemicerebella of five male healthy rabbits and found the total number of Purkinje cells to have a mean of 671,597. The mean volume of the Purkinje cell was estimated at 2207 μm3 for the entire cerebella. The contribution of the stereological method to cell quantification and volumetry was emphasised by the neuroanatomical experimental animal study. The method proved to be an excellent tool for evaluating the Purkinje cell numbers and volumes in the rabbits. The data may also support the significance of considering anatomical data when evaluating pathological changes in cerebella. (Folia Morphol 2011; 70, 4: 240–244

Volumetric evaluation of hemicerebellar changes in migraine patients without aura

Brain balance changes have been recognised in migraine, but cerebellar function between or during attacks has been assessed only in a few studies. Previous studies have indicated that migraine affects cerebellar function. In the present study we aimed to evaluate the hemicerebellar volume changes of patients with migraine without aura (MWoA). Volumetric changes of cerebellar hemispheres were evaluated in terms of asymmetry using stereological methods on magnetic resonance images (MRI) retrospectively. Nineteen patients with MWoA and 18 age- and gender-matched control subjects were included in the study. MRIs were analysed by using the point-counting approach of stereological methods by Cavalier’s principle. There was no statistically significant cerebellar atrophy or hemicerebellar asymmetry between the MWoA and control subjects. There was no cerebellar atrophy or asymmetry between the MWoA and age-matched control group. The stereological evaluation of cerebellar asymmetry and atrophy in humans is important for both clinicians and anatomists. The technique is simple, inexpensive, and reliable. (Folia Morphol 2011; 70, 4: 235–239

Intubation difficulty due to cervical osteophytes (case report)

Cervical osteophytes are hypertrophic lesions and they are generally asymptomatic. If symptomatic, the symptoms are usually dysphagia, odynophagia, otalgia. They rarely cause dyspnea. Respiratory distress due to cervical osteophytes was reported in only a few cases in English medical literature. Besides mechanical obstruction in the airway they may cause ulcerations and edema at postericoid region and all these may lead to emergency conditions (i.e. intubation difficulty) during anesthesia induction. A 68 year old male patient with complaints of walking difficulty, numbness and pain in the right leg was admitted to neurosurgery department of our institution. After physical examination and radiological evaluation a diagnosis of lumbar disc hernia was decided. A very mild dyspnea complaint was obtained from the history. Lateral neck radiogram revealed cervical osteophytes narrowing the airway. An operation was planned for lumbar disc hernia. Before the operation precautions against possible intubation difficulty during anesthesia induction were taken. As predicted before the operation, the patient could not be intubated endotracheally and a surgical tracheostomy was performed by an otolaryngologist. The cervical osteophytes were resected in a second operation by median pharyngotomy route by otolaryngologic surgeons. In this report, unexpected airway problems in asymptomatic or minimally dyspncic patients like ours were discussed and the anesthetic management of this kind of patients are summarized

Evaluation of cerebellar asymmetry in Alzheimer's disease: A stereological study

PubMed: 19602887Objectives: Alzheimer's disease (AD) is the most common cause of dementia and, as previous studies have indicated, degenerative changes in the cerebellum occur in AD. It is well known that the cerebellum does not have a symmetric morphology and some pathological disorders, such as schizophrenia, epilepsy, autism and alcoholism, can cause asymmetrical changes in the cerebellum. In this study, we aimed to evaluate whether or not patients with AD show cerebellar asymmetry. We also intended to depict the probable volumetric asymmetry by using a stereological technique. Materials and Methods: The study evaluated the volu- metric measurements of each cerebellar hemisphere by applying a stereological method to MR images. This age- and gender-matched study was composed of 15 patients with probable AD and 14 healthy subjects (controls). MR images were analyzed by using the point-counting approach, holding to Cavalieri's principle. Results: Although there was significant cerebellar atrophy in AD patients, the study showed no statistically significant cerebellar asymmetry according to age and gender, both in the study and control groups (p > 0.05). Conclusions: There was no difference in cerebellar asymmetry associated with age and gender between the AD patients and control subjects. The stereological evaluation of cerebellar asymmetry correlating with gender is of importance to both clinicians and anatomists. The technique is simple, inexpensive, reliable and unbiased. Copyright © 2009 S. Karger AG

Vertigolu olgularda cerebellar asimetrinin değerlendirilmesi

PubMed: 19263348Aim: We aimed to evaluate the relevant methods of stereology to estimate cerebellar asymmetry according to gender in both adult right-handed vertigo cases and healthy cases. Material and Methods: The study included 14 adult control subjects and 18 patients with vertigo. The volumes of the cerebellar hemispheres were determined on MRI using the point-counting approach of stereological methods. Results: The mean (±SD) of the right cerebellar hemispheres in the patients with vertigo were 52.49±5.42 cm3 in males, 50.11±4.02 cm3 in females. The mean (±SD) of the left cerebellar hemispheres in the patients with vertigo were 53.11±3.70 cm3 in males and 49.73±4.69 cm3 in females. There was no significant quantitative evidence detected in terms of cerebellar asymmetry between sagittal plane estimates in the cases with vertigo in both genders (p>0.05). There were no statistically significant differences by genders between vertigo and control subjects (p>0.05). There was statistical significance only between right and left hemispheres in male control subjects (p=0.039) Conclusion: There was no cerebellar asymmetry between control and vertigo cases by gender. The stereological evaluation of cerebellar asymmetry or atrophy in humans in correlation with gender is of importance both for clinicians and anatomists. The technique is simple, reliable, inexpensive and unbiased