A morphological study of the posterior communicating artery

This study aims to identify and yield a better understanding of the origin of the posterior communicating artery, its perforating branches and the relations in the vicinity of that artery. In 30 brains filled with a mixture of latex through the internal carotid and basilar arteries the posterior communicating artery originated from the posterior aspect of the C4 part of the internal carotid artery in 20 hemispheres (66.6%) and from its postero-lateral part in 8 hemispheres (26.6%). In 2 hemispheres (6.6%), however, it originated from the anterior aspect of the internal carotid artery. In 8 hemispheres (26.6%) a foetal type of posterior communicating artery was observed. It was 11.94 mm (8.03–15.07 mm) in length from the origin of the PCoA to the point of union with the posterior cerebral artery. The PCoA gave 5, 8 perforating branches (4–9). The distance of the origin of these branches from the origin of the PCoA was 3.30 mm (0.06–9.05) and the area occupied by the origins of the perforating branches was 4.53 mm (0.01–9.07). The perforating branches of the posterior communicating artery were generally dense in the initial 2/3 of the artery. Consequently, the posterior third of the posterior communicating artery seems to be a safer area during surgical operations. As the perforating branches are dense in the initial 2/3 of the artery, this region is at highest risk of damage during operations

Neurovascular relationship between abducens nerve and anterior inferior cerebellar artery

We aimed to study the neurovascular relationships between the anterior inferior cerebellar artery (AICA) and the abducens nerve to help determine the pathogenesis of abducens nerve palsy which can be caused by arterial compression. Twenty-two cadaveric brains (44 hemispheres) were investigated after injected of coloured latex in to the arterial system. The anterior inferior cerebellar artery originated as a single branch in 75%, duplicate in 22.7%, and triplicate in 2.3% of the hemispheres. Abducens nerves were located between the AICAs in all hemispheres when the AICA duplicated or triplicated. Additionally, we noted that the AICA or its main branches pierced the abducens nerve in five hemispheres (11.4%). The anatomy of the AICA and its relationship with the abducens nerve is very important for diagnosis and treatment

Tendon Interposition and Ligament Reconstruction with ECRL Tendon in the Late Stages of Kienböck’s Disease: A Cadaver Study

Background. The optimal surgical treatment for Kienböck’s disease with stages IIIB and IV remains controversial. A cadaver study was carried out to evaluate the use of coiled extensor carpi radialis longus tendon for tendon interposition and a strip obtained from the same tendon for ligament reconstruction in the late stages of Kienböck’s disease. Methods. Coiled extensor carpi radialis longus tendon was used to fill the cavity of the excised lunate, and a strip obtained from this tendon was sutured onto itself after passing through the scaphoid and the triquetrum acting as a ligament to preserve proximal row integrity. Biomechanical tests were carried out in order to evaluate this new ligamentous reconstruction. Results. It was biomechanically confirmed that the procedure was effective against axial compression and distributed the upcoming mechanical stress to the distal row. Conclusion. Extensor carpi radialis longus tendon has not been used for tendon interposition and ligament reconstruction in the treatment of this disease before. In view of the biomechanical data, the procedure seems to be effective for the stabilization of scaphoid and carpal bones

Clinical importance of ligamentous and osseous structures in the cervical uncovertebral foraminal region

The vertebral artery, cervical spinal nerves, spinal nerve roots, and the bony and ligamentous tissue related to the cervical vertebrae are structures whose anatomy determines the path of a surgical approach. Defining the anatomy and, in particular, determining the precise location of vulnerable structures at the intervertebral foramen and the uncovertebral foraminal region (UVFR), a region defined by the uncinate process anteriorly, the facet joint posteriorly and the foramen transversarium laterally, has critical significance when selecting the safest surgical approach. We studied the anatomy of the vertebral artery, cervical spinal nerves, and spinal nerve roots within the UVFR in six cadaver specimens. We also obtained measurements of bony structures in 35 dry cervical vertebral columns, from C3-C7. The uncinate process (UP) projects superiorly from the posterolateral aspect of each cervical vertebral body, except for the first and second vertebrae. Because the posterior part of the UP lies adjacent to the vertebral artery, spinal nerve, and spinal nerve roots, its resection creates sufficient space to decompress these structures directly. The posterolateral surface of the UP is covered by ligamentous tissue that originates from the posterior longitudinal ligament and protects the neural and vascular structures during their decompression in the UVFR

Melatonin Supplementation Ameliorates Energy Charge and Oxidative Stress Induced by Acute Exercise in Rat Heart Tissue

Background: Regular physical exercises may help people to be more resistant to everyday problems; however, how acute and intense exercises affect the heart tissues functioning with maximum capacity and how melatonin changes the effect of acute and intense exercises are still not obvious. We aimed to comprehend whether melatonin intravenous injection supports the oxidative/antioxidative conditions and energy charge in heart tissues of rats exposed to acute swimming exercise

Use of pediatric epidural catheter in ophtalmic regional anaesthesia: A cadaver study

Oftalmik rejiyonal anestezi, günübirlik cerrahi uygulanmasına olanak sağlaması, ameliyat sırasında hasta ile kooperasyonun devam etmesi ve özellikle yandaş hastalığı olan geriyalrik hasta grubunda sistemik etkilerinin azlığı nedeni ile tercih edilmektedir. Günümüzde yaygın olarak kullanılan rejiyonal anestezi teknikleri olan retrobulbar ve peribulbar blok uygulaması sırasında çok ince iğne kullanımına bağlı olarak perforasyon ve intraorbital kanama gibi ciddi komplikasyonlar görülebilmektedir. Komplikasyon olasılığı enjeksiyon tekrarı ile artmaktadır. Bu çalışmada, pediyatrik epidural anestezi pratiğinde kullanılan iğne ve kateterin oftalmik rejiyonal anestezideki etkinliği kadavra çalışması ile belirlenmeye çalışıldı. Çalışma, orbitofasyal bölgede herhangi bir patolojisi olmayan beş kadavrada (ölüm yaşları 67-83) planlandı. Tuohy iğnesi ile orbitalara bilateral, peribulbar anestezi tekniğine uygun olarak girildi. Kateter yerleştirildi. Her bir orbita için 4 mL radyoopak madde verildi. Orbitaların tomografık kesitleri alındı. İnce disseksiyon ile uygulamanın orbita içi dokulara etkisi belirlendi. Tomografık kesitlerin radyolojik görünümleri radyoopak maddenin homojen dağılım gösterdiğini belirledi. Disseksiyon sırasında glob veya periorbital dokularda herhangi bir doku hasarına rastlanmadı. Pediyatrik rejiyonal anestezi pratiğinde kullanılan iğne ve kateterin oftalmik rejiyonal anestezide kullanılabileceği kanısına varıldı. Steril set olarak bulunması, kateterin uzun süren operasyonlarda reenjeksiyon olasılığını ortadan kaldırması, iğne üzerinde fazla ilerlemeyi önleyecek belirteçlerin bulunması ve aynı amaçla kullanılan irrigasyon kanülünden daha ince olması üstünlükleri arasında sayılabilir.Regional anaesthesia is preferred in ophthalmic surgery in that it allows day-case procedures, cooperation with the patient and that it has fewer systemic effects especially in geriatric patients with accompanying disease. Serious complications such as perforation and intraorbital hemorrhage may, occur due to use of very fine needles during retrobulbar and peribulbar block, which are frequently used in regional anaesthesia techniques at present. In this cadaver study, we investigated the efficacy of the needle and the catheter used in practice of pediatric epidural anaesthesia in ophthalmic regional anaesthesia. The study was performed on five cadavers without any pathology in orbito-facial region (age at death was between 67 and 83 years). Orbits were entered by using Tuohy needle in accordance with peribulbar anaesthesia and a catheter was placed. Each orbit was administered 4 ml radioopaque medium. CT scanning of orbits was performed. The effect of fine dissection on intraorbital tissues was determined. CT scanning showed homogenous distribution of radioopaque medium. No damage to globe or periorbital tissues was observed during dissection. It was concluded that the needle and the catheter used in practice of pediatric regional anaesthesia can be used in ophthalmic regional anaesthesia. They have the advantages that they are available as sterile sets, the catheter obviates the need for reinjection following prolonged operations, there are markings on the needle, preventing further progression into tissues, and that it is finer than irrigation cannula used for the same purpose

Melatonin Supplementation Ameliorates Energy Charge and Oxidative Stress Induced by Acute Exercise in Rat Heart Tissue

Background: Regular physical exercises may help people to be more resistant to everyday problems; however, how acute and intense exercises affect the heart tissues functioning with maximum capacity and how melatonin changes the effect of acute and intense exercises are still not obvious. We aimed to comprehend whether melatonin intravenous injection supports the oxidative/antioxidative conditions and energy charge in heart tissues of rats exposed to acute swimming exercise

Regional anatomic structures of the elbow that may potentially compress the ulnar nerve

WOS: 000267812400021PubMed: 19481960Hypothesis: Traumatic injuries to the ulnar nerve at the elbow are a frequent problem as it is vulnerable to stretching and compression with motion of the upper limb. The aim of the present study was to explore the course of the ulnar nerve at the elbow and forearm and to determine possible anatomical structures that may cause compression of this structure. Materials and methods: We examined 12 upper limbs from cadavers. The length of any fibrous bands, and if present, their distance to the medial epicondyle was recorded. Results: On 5 sides a fibrous band originating from the medial intermuscular septum was observed to cross over the ulnar nerve. The average length of the fibrous band was 5.7 cm, and it attached to the medial epicondyle. The mean length of the ulnar nerve as it coursed in the cubital tunnel was 3.8 cm. In 4 of the cases, the ulnar nerve was covered by muscle fibers originating from the flexor digitorum superficialis and extending to the flexor carpi ulnaris. On 5 sides we observed fibrous thickenings, and on 8 sides vascular structures were found crossing over the ulnar nerve. Discussion: The cubital tunnel is the most common site of compression of the ulnar nerve. Numerous surgical procedures are recommended for cubital tunnel syndrome. Simple decompression is used most commonly. Although surgical procedures are reported to provide efficient pain relief and functional recovery, residual or recurrent symptoms have been reported. Reasons for such recurrences may be more proximal or distal compression of the ulnar nerve as seen in our study. Conclusion: Knowledge of possible compression sites of the ulnar nerve is important to the surgeon so that complications are avoided and postoperative recurrence is decreased. Level of evidence: Basic science study. (C) 2009 Journal of Shoulder and Elbow Surgery Board of Trustees