The recurrent artery of Heubner (RAH) is the largest vessel of the medial lenticulostriate arteries. It supplies many deep structures, mainly the corpus striatum, the globus pallidus, and the anterior crus of the internal capsule. The aim of the present paper was studying the morphological variations of the RAH and its diameter in relation to different areas of origin. The series contained the records from 183 formalin-fixed adult human brains. The calibrated digital images of the studied brains were evaluated and measured by Image J, which can calculate the number of pixels and convert them to metric measures. The RAH arose most often from the postcommunicating part of the anterior cerebral artery (47.81%). It originated from the precommunicating part of the anterior cerebral artery in 3.55% and at the level of the anterior communicating artery in 43.4% of cases. The RAH was missing in 5.19% and doubled in 6.28% of cases. The mean outer diameter of the RAH was 0.6 mm. The maximal measured diameter was 1.34 mm, and the minimal diameter was 0.19 mm. The awareness of the various anatomical and morphometric variations of the RAH is essential in planning the neurosurgical procedures to avoid unexpected neurological complications.

Current understanding of the neuroanatomical abnormalities in autism includes gross anatomical changes in several brain areas and microstructural alterations in neuronal cells as well. There are many controversies in the interpretation of the imaging data, evaluation of volume and size of particular brain areas, and their functional translation into a broad autism phenotype. Critical questions of neuronal pathology in autism include the concept of the reversible plasticity of morphological changes, volume alterations of brain areas, and both short- and long-term consequences of adverse events present during the brain development. At the cellular level, remodeling of the actin cytoskeleton is considered as one of the critical factors associated with the autism spectrum disorders. Alterations in the composition of the neuronal cytoskeleton, in particular abnormalities in the polymerization of actin filaments and their associated proteins underlie the functional consequences in behavior resulting in symptoms and clinical correlates of autism spectrum disorder. In the present review, a special attention is devoted to the role of oxytocin in experimental models of neurodevelopmental disorders manifesting alterations in neuronal morphology.

Abstract:Background: The course of the brachial plexus, its relations with surrounding structures and unique primary and secondary divisions result in its wide range of anatomical variations. Most of these variations were detected during anatomical dissections and studies. It has been found that 53% of studied brachial plexuses contained variations. The communication between musculocutaneous and median nerves is the most common variation of infraclavicular part of brachial plexus. Methods: During gross anatomical dissections of peripheral nerves, we observed neuronatomical variations in upper limbs of four formalin embalmed adult cadavers. Musculocutaneous and median nerves were connected by a communicating branch at distinct level in each cadaver. The formation and relations of both nerves were noted in each case to exclude the existence of other anatomical variations. The connections were measured and documented by digital camera. Results: The communicating fi bers of variations 1 and 2 were located in the upper third of arm and proximally to musculocutaneous nerve penetration through coracobrachialis muscle. In variations 3 and 4, the communicating branch was situated in the lower third of arm and distal to the nerve penetration point. Conclusion: Variable interconnections between musculocutaneous and median nerve have to be considered in diagnosis of nerve lesions in axillary and arm regions. Compound musculocutaneous and median nerve neuropathy would occur in lesions of the interconnecting branches. Injuries of musculocutaneous nerve proximal to these branches can cause particular and unexpected symptoms, such as weakness of forearm fl exors and thenar muscles (Fig. 6 The brachial plexus is formed by the anterior rami of the cervical nerves C5-C8. It receives variable connections from the anterior rami of the fourth cervical nerve (C4) and the fi rst thoracic nerve (T1). The prefi xed type of the plexus is characterized by thick contributive nerve fi bers from C4 and thin or absent fi bers from T1. In the constitution of the postfi xed brachial plexus the fi rst two thoracic nerves (T1-T2) with absence of the nerve connection from C4 take part. The prefi xation of the plexus is more common than its postfi xation (1, 2).The roots of the plexus lie in the posterior cervical triangle between the anterior and middle scalene muscles. The nerve roots unite to form complex nerve network, from which the three primary trunks of the brachial plexus are branching: superior middle and inferior trunks. These are passing together with the subclavian artery under the clavicle and through the scalene gap. Each trunk is divided into anterior and posterior divisions. The lateral, medial and posterior cords of the plexus are formed by these divisions in the axillary fossa. The cords are named according to their relative position around the axillary artery (3, 4).From the topographical point of view the plexus is divided into supraclavicular and infraclavicular parts. The supraclavicular part gives off branches to innervate th...

BACKGROUND: Fracture of the lateral border of the distal tibia is often referred as Tillaux fracture. It is an avulsion fracture due to the tension of the anteroinferior portion of the anterior tibiofi bular ligament (1). This type of fracture is scarce in adulthood and can be easily overlooked. METHODS: From 2006 to the present day, 7 case reports describing the Tillaux fracture were found in the PubMed and Web of Science database, to which one case from our set of patients was added. Our goal was to focus on the diagnostic and a selected treatment described in each published case. RESULTS: We found no gender difference. The injury mechanism was mostly an external rotation. Treatment and diagnosis were, in all cases differentiated at specifi c points. Fixation and load reduction were indicated at least for six weeks in all of the patients. After three months, in almost all cases, a return to full function was achieved. CONCLUSION: Our assessments are not statistically signifi cant, but our goal was to point out the existence of such a rare type of fracture. At the same time, based on previous publications, we developed an algorithm of diagnosis and treatment to facilitate the management of this type of fracture

BACKGROUND: Various authors defi ned three patterns of the posterior part of the circulus arteriosus cerebri Willisi (CW) according to the diameter of the posterior communicating artery (PCoA) and the precommunicating segment of the posterior cerebral artery (P1). In the adult pattern, the P1 has a diameter larger than the nonhypoplastic PCoA. In the transitional pattern, the diameter of the PCoA is equal to that of the P1. In the fetal pattern, the diameter of the P1 is smaller than the diameter of the PCoA. The study was aimed to evaluate the confi gurations and calibers of the posterior part of the CW. METHODS: The work was conducted on 185 adult post-mortem brains. The CW and its branches were photographed by a digital camera. We used the software Image J to evaluate and process the gained images. RESULTS: The fetal pattern was found unilaterally in 8.37 %, and bilaterally in 4.86 %. The transitional pattern was observed unilaterally in 6.47 %, and bilaterally in 1 %. The prevalence of the unilateral and bilateral adult patterns was equal (21.62 % for each confi guration). The hypoplastic PCoA was found unilaterally in 17.57 %, and bilaterally in 16.76 %. CONCLUSION: Various factors including genetic and environmental may affect the development of the cerebral vessels and their dimensions. The distinguishing of the vascular dimensions in vivo can help in the expectation and may be the avoidance of possible cerebrovascular disturbances in the future. Correlation and interdisciplinary cooperation of the studies dealing with morphology, radiology, and hemodynamics of the cerebral vessels are becoming an urgent need. The assumed results of this cooperation can be used in tabulating the calibers of the cerebral vessels and determining the threshold dimensions under which failure of hemodynamics and collateral function may appear (Tab. 2, Fig. 5, Ref. 28). Text in PDF www.elis.sk. . KrishnamurthyA, Nayak SR, Ganesh Kumar C. Morphometry of posterior cerebral artery: embryological and clinical signifi cance. Roman J Morphol Embryol 2008; 49 (1): 43-45. 27. Chuang YM, Liu CY, Pan PJ, Lin CP. Posterior com municating artery hypoplasia as a risk factor for acute ischemic stroke in the absence of carotid artery occlusion. J Clin Neurosci 2008; 15 (12): 1376-1381. 28. Sahni D, Jit I, Lal V. Variations and anomalies of the posterior communicating artery in northwest Indian brains. Surg Neurol 2007; 68 (4): 449-453.

Fat-rich diet (FRD) triggers health complications like hypertension, dyslipidemia, hyperglycemia, insulin resistance and non-alcoholic fatty liver disease, known as the risk factors of metabolic syndrome (MetS), which may result in neurological deficits. The impact of MetS on neuronal functions and brain morphology are poorly understood. We induced MetS-like conditions by exposing hypertriacylglycerolemic (HTG) rats to FRD for eight weeks with the aim to study possible neurological dysfunctions. HTG-FRD rats were compared to HTG rats and Wistar rats on standard diet. The physiological status of the animals was monitored by body, liver and kidney weight (wt). Morphology of the liver, vessel wall and hippocampus were investigated. Basal neurotransmission and synaptic plasticity were measured in the hippocampus ex-vivo. A marked increase of liver weight with marks of steatosis was found in the HTG-FRD group. FRD induced an increase of aortic intima-media thickness. Extracellular recording revealed FRD-induced impairment of long-term potentiation (LTP) at Cornu Ammonis (CA)3-CA1 synapse, contrary to increased presynaptic fiber volley (pV). Reduced thickness of pyramidal cell layer at the CA1 area was found morphometrically. LTP was directly associated with kidney weight and inversely associated with liver weight, pV directly correlated with liver weight, liver wt/body wt ratio and aortic intima-media thickness. Our results suggest correlations between altered physiological status due to MetS-like conditions and neurological deficits, which may be related with consecutive development of socalled metabolic cognitive syndrome.

OBJECTIVES: Although appendicitis is a common disease, basic questions about risk factors and its etiology remain unexplained. BACKGROUND: An obstruction of the appendix lumen is usually considered to be the main cause of acute appendicitis. However, more studies are currently dealing with neuroimmune appendicitis. METHODS: We studied samples of human appendices with the histological diagnosis of chronic appendicitis. Fixed cryosections of appendiceal walls were examined by immunofl uorescence methods using neuronal antineurofi lament antibody markers and beta III tubulin. RESULTS: The immunostaining revealed an irregular distribution of myenteric ganglia in infl amed appendiceal walls and unexpected groups of large ganglia unequally distributed in the subserosal area. The comparative analysis of normal and infl amed appendix samples showed differences in the occurrence of myenteric ganglia in the subserosal area. They appeared more frequently on cryosections prepared from the infl amed appendiceal wall. CONCLUSION: We propose that the high variability and irregular location of myenteric ganglia in the appendiceal wall are due to an alteration in the motility which results in fl accid appendix emptying. In addition, superfi cially located myenteric ganglia are exposed to abdominal irritation and may explain the chronic abdominal pain which is often considered to be a sign of chronic appendicitis (Fig. 2, Ref. 23). Text in PDF www.elis.sk.

Abstract:Background: Congenital anomalies of the abdominal wall are classifi ed as anomalies with the abdominal wall defect (omphalocele, gastroschisis) and without the defect (umbilical hernia, persistent ductus omphaloentericus or urachus). Clinical presentations of these conditions are different, and so is the timing of surgical intervention and approach with or without the exploration of the peritoneal cavity. Case: The presented case report refers to a rare fi nding of ectopic liver forming mesodermal cyst within the umbilical region. Full term neonate girl with 5 cm spheroid tumor in umbilicus was otherwise without problems. Ultrasonography (USG) of the lesion detected a tissue with good vascularization and a cystic cavity. There was no fl ow in the umbilical vessels and no evidence of intestinal loop in the sac. USG of the liver was normal. During surgery an additional narrow canaliculus was identifi ed connecting the spheroid along with umbilical vessels to the liver. The whole spheroid together with the canaliculus was surgically removed without exploration of the abdominal cavity. Histological evaluation of the surgical specimen discovered liver tissue with a mesodermal cyst in the center. The sphere was connected to the liver by a bile duct. Six months after the operation the child is in a good clinical condition. Conclusion: In conclusion omphalocele may contain liver. Ectopic liver is an extremely rare condition. Surgical treatment in the presented case focused only on umbilicus without exploration of the abdominal cavity and appeared to be suffi cient. Long-term postoperative follow up typical in pediatrics will be applied also in this patient (Fig. 3, Ref. 25). Full Text in PDF www.elis.sk.