AIm: Surgical approaches to Meckel's cave (MC) are often technically difficult and sometimes associated with postoperative morbidity. The relationship of surgical landmarks to relevant anatomy is important. Therefore, we attempted to delineate quantitatively their anatomy and the relationships between MC and surrounding structures.
mAteRIAl and methods:With the aid of a surgical microscope, MC and its contents were studied in 15 formalin-fixed cadaver head specimens. Measurements were made and their relationships were observed.
Results:The distance from the zygomatic arch and the lateral end of the petrous ridge to MC was 26.5 and 34.4 mm, respectively. The distance from the arcuate eminence, the facial nerve hiatus, and the foramen spinosum to MC was 16.6, 12.8 and 7.46 mm respectively. The TG lay 5.81 mm posterior to the foramen ovale. The distance from the abducens, trochlear and oculomotor nerves to the trigeminal ganglion was 1.87, 5.53 and 6.57 mm respectively. The distance from the posterior and the anterior walls of the sigmoid sinus to the trigeminal porus was 43.6 and 33.1 mm respectively. The trigeminal porus was on average 7.19 mm from the anterior wall of the internal acoustic meatus.
ConClusIon:The anatomical landmarks as presented herein regarding MC may be used for a safer skull base approach to the region. BulGulAR: Zigamatik arkusun ve petroz kenarın lateral sonunun Meckel cave'e ortalama uzaklığı sırasıyla 26,5 ve 34,4 mm idi. Arkuat eminens, fasiyal sinir hiatus ve foramen spinosumun Meckel cave'e ortalama uzaklığı sırasıyla 16,6, 12,8 ve 7,46 mm idi. Trigeminal ganglion foramen ovale'nin 5,81 mm arkasında yerleşmiştir. Abdusens, trohlear ve okülomotor sinirlerin trigeminal gangliona ortalama uzaklıkları sırasıyla 1,87, 5,53 ve 6,57 mm idi. Sigmoid sinüsün arka ve ön duvarlarının trigeminal porus'a ortalama uzaklıkları sırasıyla 43,6 ve 33,1 mm idi. Trigeminal porus internal akustik meatusun anterior duvarından ortalama 7,19 mm uzakta idi. sonuÇ: Meckel cave ile ilgili sunulan anatomik belirteçler ve onların anatomik özellikleri ile ilgili bilgiler bu bölgeye güvenli bir yaklaşım için yararlı olabilir.
AIm: Pituitary abscess is a disorder characterized with central nervous system (CNS) infection, mass effect, and endocrine dysfunction. These abscesses generally occur due to hematogenous spread in conditions such as paranasal sinusitis, sepsis, and where the blood brain barrier breaks down. This paper aims to discuss four cases of preoperatively diagnosed pituitary abscess in the light of the literature. Results: All the patients showed fever, systemic signs of toxemia and endocrine dysfunction at the time of diagnosis. In these cases, a preoperative diagnosis of the disease was made thanks to characteristic MRI findings. The four cases were operated by the transnasal transsphenoidal approach and histopathological and microbiological studies were performed for surgical specimens.ConClusIon: Pituitary abscesses are rare disorders responsible for a high mortality risk. Mortality and morbidity can be reduced by early surgical drainage and appropriate antibiotic treatments. Additionally, these cases should be closely followed-up in terms of pituitary insufficiency, surgical complications and infection.
The risk for development of hypophyseal adenoma may be greater in patients with the 2G allele. In cases of existing hypophyseal adenoma, those with the homozygous 2G allele tend to be invasive.
Teratomas account for 3% of all childhood tumors, with the majority occurring in the sacrococcygeal region and in the ovary. Intradural spinal teratomas are extremely rare dysembryogenetic tumors. Spinal cord teratomas may be extradural, intradural or intramedullary. Intramedullary ones are the least frequently seen. We have extensively reviewed the literature for intramedullary spinal cord teratomas in children. Although an intramedullary teratoma of the conus medullaris in children is a rare entity, it should be considered in the differential diagnosis of masses involving the conus medullaris.
The purpose of this study was to investigate the relationship between Ki-67 proliferation indexes and ADC values of low-grade and atypical/anaplastic (high-grade) meningiomas. In addition, we compared the ADC and Ki-67 proliferative index values of the low-grade and atypical/anaplastic (high-grade) meningiomas. We concluded that there was an inverse correlation between the ADC and Ki-67 proliferation index values in meningiomas, and we have found statistically significant difference between the ADC values of the low-grade and high-grade meningiomas. ADC values can be used for histopathological characterization of the meningiomas and pre-surgical planning.
Background: The characteristics of Chiari malformation type III and its treatment are evaluated in this study. Radiological and surgical findings were correlated and the benefits of the therapy are discussed. Methods: Eight patients (6 males, 2 females) with Chiari malformation type III were studied. All patients underwent surgery to remove encephalocele along with neural tissue and to repair the dura and the skin. Associated pathologies such as hydrocephalus, tethered cord syndrome and syringomyelia were also surgically treated. Follow-up was based on the evaluation of postoperative motor and mental development, as well as on magnetic resonance imaging findings. Results: Ventriculoperitoneal shunt malfunction in 2 patients was the only surgical complication. One patient died 10 days after the operation, 7 patients survived, and the outcome of 2 patients was quite poor because of severe mental retardation and neurological deficits at the beginning. In the remaining patients, motor and mental development was normal, and the neurological outcome was satisfactory. Conclusion: Surgery in the newborn period, initial severity of neurological deficits, the presence of intermittent apnoea, delayed treatment of hydrocephalus and the amount of neuronal tissue within the excised encephalocele were determined as unfavourable prognostic factors for the outcome. If the appropriate surgical procedure is done at the right time, the outcome of the Chiari malformation type III patient can be satisfactory with a low mortality rate.
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