Effect of ligamenta flava hypertrophy on lumbar disc herniation with contralateral symptoms and signs: a clinical and morphometric study

Introduction: The purpose of this study was to determine whether ligamentum flavum hypertrophy among disc herniated patients causes contralateral pain symptoms For this reason we measured the thickness of the ligament in disc herniated patients with ipsilateral or contralateral symptoms

Anatomic Origin and Molecular Genetics in Neuroblastoma

Neuroblastoma is considered as the most common extracranial solid tumor occurring during childhood, but takes place rarely after the age of 10 years. The tumors are considered as embryonal tumors that result from the fetal or early postnatal life development and are formed from neural crest-derived cells, and their origination is from the early nerve cells which are called as neuroblasts of sympathetic nervous system. Being heterogeneous in their biological, genetic, and morphological characteristics, tumors which are distinct from other solid tumors due to their biological heterogeneity result in the clinical pattern changes from spontaneous regression to a highly aggressive metastatic disease. Neuroblastoma tumorigenesis is regulated by Myc oncogene, leading to aggressive tumor subset. Many epigenetic factors play crucial role in the disease induction and development, while regulatory effect and outcome result in epigenetic patterns distinguishing neuroectoderm, neural crest, and more mature neural states. Neuroblastoma patients’ clinical management is based on prognostic categories subtracted from studies correlating outcome and clinico-biological variables. Neuroblastoma anatomic boundaries include primarily autonomic nervous system besides other rare locations. Neuroblastoma molecular pathogenesis classifies the tumor according to the different clinical behaviors that are important for the improvement of the patients outcome and overall survival according to the different therapy modalities applied

Anatomical, Biological, and Surgical Features of Basal Ganglia

Basal ganglia refers to the deep gray matter masses on the deeply telencephalon and encompasses a group of nuclei and it influence the information in the extrapyramidal system. In human they are related with numerous significant functions controlled by the nervous system. Gross anatomically, it is comprised of different parts as the dorsal striatum that are consisted of the caudate nucleus and putamen and ventral striatum which includes the nucleus accumbens, olfactory tubercle, globus pallidus, substantia nigra, and subthalamic nucleus. Nucleus accumbens, is also associated with reward circuits and has two parts; the nucleus accumbens core and the nucleus accumbens shell. Neurological diseases are characterized through the obvious pathology of the basal ganglia, and there are important findings explaining striatal neurodegeneration on human brain. Some of these diseases are induced by bacterial and/or viral infections. Surgical interference can be one alternative for neuronal disease treatment like Parkinson’s Disease or Thiamine Responsive Basal Ganglia Disease or Wilson’s Disease, respectively in addition to the vascular or tumor surgery within this area. Extensive knowledge on the morphological basis of diseases of the basal ganglia along with motor, behavioral and cognitive symptoms can contribute significantly to the optimization of the diagnosis and later patient’s treatment

Evaluation of Lumbar Vertebral Body and Disc: A Stereological Morphometric Study

Anterior access to the L1-L5 vertebrae and disc spaces can be technically challenging, frequently requiring the use of an approach to a surgeon for an adequate exposure. The technique is used for lesion excision, corpectomy, vertebral body reconstruction with cages, realignment, and/or plating or screwing. For a successful anterior approach and a suitable instrumental design via screw, adequate morphometric knowledge about body of lumbar vertebrae and disc spaces and standardized volumetric data are also required for neurosurgeons. We aimed morphometric and volumetric evaluation of lumbar bodies and discs to contribute to a safe anterior approach during surgery. We evaluated vertebral body and disc morphometry using stereology in right-handed 25 adult subjects on MRI in the same population with no history of vertebral fractures and degenerative spinal disease. The shape, defining concavity index and volumetric measurements of the body L1-L5 vertebrae, morphometric parameters such as length, height, width of the vertebral body were measured. Also morphometric and volumetric analysis of discs between L1 and L5 were evaluated selected axial and sagittal slices. As expected, the average dimensions of male vertebrae are greater than those of females, but most of them do not differ statistically. Only three dimensions, the mean difference between anterior and central heights of L3, L4 and L5 showed statistically significant difference, indicating smaller central height in both males and females. The transverse and anterior-posterior diameters of the vertebral body, intervertebral disc height and volume displayed no sexual dimorphism (p>0.05). But, the intervertebral disc height and volume increased from L1 to L5 (p<0.01). Concavity indexes for all lumbar vertebrae for both sexes did not differ statistically. The method is important to estimate applying implant size and amount in decompression operations for neurosurgeons

Lumbar vertebra morphometry and stereological assesment of intervertebral space volumetry: A methodological study

The use of technology in the treatment of degenerative spinal diseases has undergone rapid clinical and scientific development. It has been extensively studied in combination with various techniques for spinal stabilization from both the anterior and posterior approach. Minimally invasive and instrumental approach via posterior fixation is increasingly being used for the treatment of adult degenerative disc disease, stenosis, and deformity of the lumbar vertebrae. Posterior access to the lumbar disc spaces for posterolateral fusion scan has been technically challenging, frequently requiring the use of an approach surgery for adequate exposure. For successful surgery and suitable instrumental design, adequate anatomical knowledge of the lumbar vertebra is also needed. Anatomic features of lumbar vertebrae are of importance for posterior screw fixation technique. The morphometry of L1-L5 has been studied to facilitate the safe application of pedicle screws. Thus, we aimed to evaluate the morphometric landmarks of lumbar vertebrae such as pedicle, vertebral body, vertebral foramen, intervertebral space height and volume for safe surgical intervention using a posterior fixation approach to offer anatomical supports for lumbar discectomy, stenosis and cases of deformity. The features of the L1-L5 vertebral body, the detailed morphometric parameters of lumbar vertebrae and the intervertebral space were analyzed using computerized tomography scan, magnetic resonance imaging and also dry lumbar vertebrae. Additionally, intervertebral space volumes were measured using stereological methods to ensure safe surgical intervention. (C) 2011 Elsevier GmbH. All rights reserved

Análisis morfométrico de la asimetría hemicerebelar en casos de vértigo central: Un estudio estereológico

We aimed to evaluate the relevant methods of stereology to estimate hemicerebellar asymmetry according to sex in both adult right handed vertigo cases and comparing with healthy cases. The study included 14 adult control subjects and 18 patients with vertigo. The volumes of the cerebellar hemispheres were determined by MRI using the point-counting approach of stereological methods. 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, 49.73±4.69 cm3 in females. There was not significant quantitative evidence detected in terms of cerebella asymmetry between sagittal plane estimates in the cases with vertigo in both genders (p>0.05). There were no statistically significant differences according to the genders between both vertigo and control subjects (p>0.05). There was only statistical significance between right and left hemispheres in male control subjects (p=0.039). There was no cerebella asymmetry between control and vertigo cases according to genders. The stereological evaluation of cerebella asymmetry or atrophy in humans correlate with gender is of importance for both clinicians and anatomists. The technique is simple, reliable, inexpensive and unbiased

Evaluation of Cerebellar and Cerebral Volume in Migraine with Aura: A Stereological Study

Migraine is associated with an increased risk of deep white matter lesions and subclinical posterior circulation infarcts. A significant association between deep white matter hyperintensities and cerebral atrophy is true for various neurological diseases; it was not specifically proven in migraine. The aim of this study was to evaluate the cerebellar and cerebral volume and volume ratios for cerebellum using the Cavalieri principle. We also aimed to examine whether migraine with aura causes cerebellar and cerebral atrophy. Twenty three right-handed patients with migraine with aura diagnosed by means of the International Headache Society criteria and 24 age-matched subjects whose only health problem was headache due to rhinosinusitis and tension type headache were included in the study. Measurements of the cerebellar and cerebral volumes as well as cerebellar/cerebral volume ratios were made using Cavalieri's principle by utilizing the point-counting methods. There were no significant differences between the volumes of cerebrum, cerebellum, and the ratio of cerebellum to cerebrum for males (p = 0.05, p = 0.10, and p = 0.64, respectively) and for females (p = 0.18, p = 0.89, and p = 0.24, respectively). Our results suggest that patients with migraine with aura do not have a significant difference in cerebellar and cerebral volumes and cerebellar/cerebral volume ratios compared to the non-migraine group