Superficial brachial artery : a case report with commentaries on the classification

Variations of the brachial plexus and median nerve relationships with the axillary and brachial artery may be significant to anatomists, radiologists, anesthesiologists, and surgeons. In some cases, the coexistence of anatomical variations of the nerves and vessels may also be a source of conflict between individual structures, e. g., entrapment neuropathy of the median nerve due to atypical (superficial to the nerve) course of the brachial artery. The presented report describes coexisting anatomical variations in the neurovascular topography within the axillary fossa, arm, forearm, and hand. The presence of the superficial brachial artery originating from the second part of the axillary artery was observed. Atypical common steam for the subscapularis, posterior humeral circumflex, double profunda brachii, and superior ulnar collateral arteries was also found deep to the median nerve roots. In the forearm, the persistent median artery contributing to the blood supply of the hand was exposed. The classification issues were also discussed

Glomangioma in the hand: diagnosis, treatment, and challenges

Introduction. In this paper, we have analysed all hand glomangioma cases referred to our clinic in the context of symptoms, time to diagnosis, and the role of surgical resection of the lesion. Material and methods. We have collected the following data: the presence of risk factors, manifestation, time to diagnosis, the treatment applied, and follow-up of patients. Results. We have collected medical records from six patients, three males and three females. The median age was 45 (IQR: 29.5–65.75). The main symptom in all patients was severe pain and tenderness. The first-choice physician(s) were: general practitioners, general surgeons, and neurologists. The median time to diagnosis was 7 (IQR: 5–10) years. The main complaint of our patients was severe pain — 9 (IQR: 9–10) on the VAS scale, which was significantly alleviated after surgical treatment — 0 (IQR: 0–0; p = 0.043). Conclusions. Extremely long times to final diagnosis, and excellent outcomes of surgical treatment, highlight the necessity of raising awareness of glomangiomas among clinicians

Revisiting the Morphology and Classification of the Paracingulate Gyrus with Commentaries on Ambiguous Cases

The anterior cingulate cortex is considered to play a crucial role in cognitive and affective regulation. However, this area shows a high degree of morphological interindividual variability and asymmetry. It is especially true regarding the paracingulate sulcus and paracingulate gyrus (PCG). Since the reports described in the literature are mainly based on imaging techniques, the goal of this study was to verify the classification of the PCG based on anatomical material. Special attention was given to ambiguous cases. The PCG was absent in 26.4% of specimens. The gyrus was classified as present in 28.3% of cases. The prominent type of the PCG was observed in 37.7% of the total. Occasionally, the gyrus was well-developed and roughly only a few millimeters were missing for classifying the gyrus as prominent, as it ended slightly anterior the level of the VAC. The remaining four cases involved two inconclusive types. We observed that the callosomarginal artery ran within the cingulate sulcus and provided branches that crossed the PCG. Based on Klingler’s dissection technique, we observed a close relationship of the PCG with the superior longitudinal fascicle. The awareness of the anatomical variability observed within the brain cortex is an essential starting point for in-depth research

Affective Neuroscience Personality Scales and Early Maladaptive Schemas in Depressive Disorders

Aim: The aim of this study was to assess the interrelationships of Young’s early maladaptive schemas with indicators of specific neural emotional systems conceptualized in Panksepp’s theory in a group of people suffering from depressive disorders. Materials and methods: The Affective Neuroscience Personality Scales (ANPS) v. 2.4. and J. Young’s Early Maladaptive Schema Questionnaire (YSQ-S3-PL) were used. Ninety (90) individuals aged 18–58, including 45 people treated for depression (DD group), were qualified to participate in the experiment. Results: The subjects in the DD group scored statistically significantly lower than the subjects from the control group (CG group) on the three ANPS scale domains, namely SEEKING, PLAY, and ANGER. The subjects with depressive symptoms scored significantly higher in the YSQ-S3-PL questionnaire on two domains of early maladaptive schemas, i.e., “Impaired autonomy and performance” and “Other-directedness”. Regression analysis results indicate that impairment of the emotional SEEKING system explains most of the variability in the following typical domains of depression: “Disconnection and rejection”, “Impaired autonomy and performance”, and “Other-directedness”. For score variability in the domain area of “Impaired limits”, the ANGER system was found to be most significant, and the FEAR system proved the same for “Overvigilance and Inhibition”. Conclusions: 1. Two domains of early maladaptive schemas are significant for the onset of depressive symptoms, namely “Impaired autonomy and performance” and “Other-directedness”, linked to difficulties in engaging in behaviors to meet one’s own needs. 2. Impairment of the neural emotional SEEKING system most significantly explains the variability in depression-typical areas of early maladaptive schemas

The High Origin of the Radial Artery (Brachioradial Artery): Its Anatomical Variations, Clinical Significance, and Contribution to the Blood Supply of the Hand

Background. This study thoroughly analyzes the anatomic variations of the brachioradial artery (radial artery of high origin) based on the variability of its origin, the presence and types of anastomosis with the brachial artery in the cubital fossa (“cubital crossover” or “cubital connection”), and the pattern of radial recurrent arteries, as well as the vascular territory within the hand. Material and Methods. One hundred and twenty randomly selected, isolated upper limbs fixed in 10% formalin solution were dissected. Results. The radial artery was found to have a high origin in 9.2% of total number of the limbs: two cases from the axillary artery; nine cases from the brachial artery. Anastomosis between the brachioradial and “normal” brachial arteries in the cubital fossa was also frequently observed (54.6%). The anastomosis (“cubital crossover”) was dominant in one case, balanced in three cases, minimal in two cases, and absent in five cases. Conclusions. The brachioradial artery may originate from the brachial and, less frequently, from the axillary artery. Anastomosis between the brachioradial and “normal” brachial arteries in the cubital fossa may be dominant, balanced, minimal, or absent. A complete radioulnar arch was found more often when the brachioradial artery was present as a variant

Anatomical Variations of the Pectoralis Major Muscle: Notes on Their Impact on Pectoral Nerve Innervation Patterns and Discussion on Their Clinical Relevance

Background. The presented study attempts to classify individual anatomical variants of the pectoralis major muscle (PM), including rare and unusual findings. Rare cases of muscular anomalies involving the PM or its tendon have been presented. An attempt has also been made to determine whether anatomical variations of the PM may affect the innervation pattern of the lateral and medial pectoral nerves. Material and Methods. The research was carried out on 40 cadavers of both sexes (22 males, 18 females), owing to which 80 PM specimens were examined. Results. Typical PM structure was observed in 63.75% of specimens. The most frequently observed variation was a separate clavicular portion of the PM. In one female cadaver (2.5% of specimens) the hypotrophy of the clavicular portion of the PM was noticed. In two male cadavers (5% of specimens) the fusion between the clavicular portion of the PM and the deltoid muscle was observed. In one of those cadavers, small sub-branches of the lateral pectoral nerve bilaterally joined the clavicular portion of the deltoid muscle. The detailed intramuscular distribution of certain nerve sub-branches was visualized by Sihler’s stain. PM is mainly innervated by the lateral pectoral nerve. In all specimens stained by Sihler’s technique, the contribution of the intercostal nerves in PM innervation was confirmed. Conclusions. Surgeons should be aware of anatomic variations of the PM both in planning and in conducting surgeries of the pectoral region