Persistent primitive hypoglossal artery: an incidental autopsy finding and its significance in clinical practice

Persistent primitive hypoglossal artery (PPHA) is a recognised, albeit infrequent, intracranial vascular anomaly usually detected during angiography. Its presence is associated with an increased incidence of aneurysm, arteriovenous malformation and ischaemic stroke. A unique case of PHHA discovered during autopsy is described. Additionally, the significance of PPHA in neuroscience is discussed in detail

A study on the morphology of the popliteus muscle and arcuate popliteal ligament

The aim of this study was to investigate the origins and morphological features of the popliteus muscle in cadavers. In a sample of 40 lower limbs taken from cadavers the exact morphological features of the popliteus muscle were examined. In 100% of the cases studied we noticed, apart from the known femoral origin from the lateral femoral epicondyle, a fibular origin from the styloid process of the head of the fibula directed obliquely and blending with the main femoral origin, forming the arms of a Y-shaped structure. In all the cases a capsular origin was presented, while in 91.67% an origin lateral to it from the superior border of the posterior horn of the lateral meniscus was found. The capsular and meniscal origins formed the base of the Y-shaped structure that corresponded to the known arcuate ligament. We consider that the additional origins of the popliteus muscle form the arcuate ligament, which is not a distinct anatomical structure as it is described in traditional anatomical textbooks. In addition, we have analysed the exact morphological features of the capsular, fibular and meniscal origins of the popliteal muscle

The persistence of the sciatic artery

The persistent sciatic artery (PSA) is a rare anatomical variant where the internal iliac artery and the axial artery of the embryo provide the major supply of the lower limb, the superficial femoral artery being usually poorly developed or absent. We describe an extremely large right PSA in a 79-year-old male cadaver during a medical gross anatomy course, with simultaneous existence of a hypoplastic superficial and deep femoral artery. The PSA, which was a continuation of the anterior division of the right internal iliac artery, entered the buttock through the greater sciatic foramen situated in the gluteal region laterally to the sciatic nerve and in the mid thigh medially to the same nerve, becoming in the popliteal fossa the popliteal artery. Neither the superficial nor the deep femoral artery had communication with the popliteal artery. Because the PSA in our study was the only blood supply to the lower limb, we present the embryologic origins and the clinical anatomy of this artery

Evidence of lateral antebrachial cutaneous nerve entrapment during autopsy

Compression of the lateral cutaneous nerve of the forearm is a rare clinical entrapment syndrome. This report describes the compression of the lateral antebrachial cutaneous nerve at the level of the lateral margin of the biceps brachii tendon identified during autopsy. This is the first cadaveric case reported in the literature. The anatomy, the possible areas of entrapment, the most frequent diagnostic problems and the main therapeutic options for this rare occurrence are also discussed

Bilateral double testicular arteries: a case report and review of the literature. Potential embryological and surgical considerations

The aberrancies concerning the number, origin and course of the testicular arteries are found in an incidence of approximately 4.7–20% in the literature and are documented less frequently than the respective variations of the homonymous veins. In the current study, a very rare complex of testicular arteries’ variations isdescribed, in which the occurrence of bilateral double testicular arteries is recorded. Particularly, apart from the normal testicular arteries on each side, we observed an additional right testicular artery originated from the ipsilateral renal artery and an additional left testicular artery taking its origin from the abdominal aorta just above the renal artery’s origin site; the latter additional testicular artery arched above the left renal vein. Both, the bilateral double testicular arteries accompanied the testicular vein on each side as their satellite arteries. We discuss the potential embryological development of that complex of arterial variants, their likely clinical and surgical applications, as well as we proceed on a brief review of the relevant literature

An accessory middle scalene muscle causing thoracic outlet syndrome

The aim of our study is to present a very rare accessory middle scalene muscle, leading to thoracic outlet syndrome. In particular, a muscular bundle was discovered on a male cadaver connecting the middle portion of the middle scalene muscle with the anterior scalene muscle insertion to Lisfranc`s tubercle. This triangular accessory muscle and, especially, its sharp medial border compressed the middle and lower trunk of the brachial plexus and the subclavian artery. This anomaly is of great importance because it emphasises the fact that it is not primarily the anterior scalene muscle that produces symptoms of thoracic outlet syndrome but the anterior displacement of the middle scalene muscle or its accessory muscular bands. We also present the relative international literature and the clinical significance of our finding

Morphological parameters of the acromion

The purpose of this study was to record the basic morphometric values of the acromion. Forty-four pairs of dried scapulas were reviewed. Acromial shape was evaluated in relation to sex, symmetry and presence of subacromial enthesophytes and classified according to Bigliani with the following results: type I (flat): 26.1%, type II (curved): 55.6% and type III (hooked): 18.1%. There was a greater percentage of type III in men (56.2% vs. 43.7%) and type I in women (56.5% vs. 43.4%). Acromial morphology was symmetric in 29 acromia (65.9%). Enthesophytes were most common in type III (75%). A rough inferior surface of the acromion was most frequently found in type III (81.2%). Nine other scapular osteological parameters were also measured. Many differences were noted between male and female scapulae. The great variety of morphological features is assumed to be related to rotator cuff pathology and other shoulder impairments

Uncomplicated intraoperative evaluation of an aberrant bile duct: a case report and review of the literature

The presence of aberrant bile ducts is a significant risk factor for bile duct injuries during cholecystectomy. Identification of such anatomic anomalies of the biliary tree is crucial to prevent iatrogenic biliary injuries. For that purpose many methods, both preoperative and intraoperative, have been described with controversial results. We present a case of an aberrant right hepatic duct that was found during laparoscopic cholecystectomy with the use of intraoperative cholangiography and review the literature

Excavated type of rhomboid fossa of the clavicle: a radiological study

The excavated type of rhomboid fossa of the clavicle is a relatively neglected anatomical structure that can potentially cause diagnostic problems. Its unilateral occurrence may be confused by the physician as avascular necrosis, osteomyelitis, or even a tumour. We studied 80 routine chest radiographs and identified the clavicles with excavated type of rhomboid fossa. The sex, sidedness, and handedness were recorded. An excavated type of rhomboid fossa was present in 43 clavicles (26.88%), appearing more frequently in males than in females. In addition, the incidence of the excavated type of rhomboid fossa was greater on the right side than on the left. That type of fossa was also present more frequently on the right side in right-handed specimens and on the left side in left-handed specimens. The high incidence of the excavated type of rhomboid fossa on the dominant hand supports the mechanical theory of fossa formation. Radiologists and physicians should be aware of this fossa, as it may resemble a pathological condition