The craniovertebral junction area refers to the osseous structures consisting of the occipital bone that surrounds the foramen magnum, the atlas, and the axis vertebrae. There is sparse literature about the morph metric measurement of craniovertebral junction region. We aim to derive a range of various measurements incraniovertebral junction area. This is a hospital based single center retrospective study conducted in our center among 100 consecutive computed tomography scans of craniovertebral junction obtained in adult patients who were admitted to our tertiary hospital for treatment of non-craniovertebraljunction conditions between 2017 and 2018.Various craniovertebral junction morphology parameters were measured and confidence interval at 95% were obtained the range at 2standard deviation. Among 100 patients studied, 51% of them were males while 49% were females. Mean age was 35.1±10.4 years with range from 15 to50 years. Computed tomography measurement of craniovertebral junction revealed meanders height of 30.8±2.5 mms, dento-clivaldistance was 5.9±1.6 mms and mean McRae’s distance of 34.2±2.49 mms. Similarly, anterioratlantodental interval was calculated to be1.83±0.47 mms and posterior atlantodentalinterval was 17.72±0.21 mms while Modified RW distance was 24.43±2.09 mms and Redlund Johnell distance was calculated to be 31.5±4.29mms. Normal morphometric measurements ofcraniovertebral junction can be useful for evaluating abnormalities of the craniovertebraljunction which can potentially improve the diagnostic criteria of most abnormalities.
Introduction: The skull’s main function is to protect the brain. Total skull bone thickness is the total thickness of diploe and the external and internal tables. The measurement of the human skull based on CT images results are of great practical value in the fields of anatomy, clinical medicine, biomechanics study and head injury analysis. There are few literatures about imaging assisted measurement of the cranial vault thickness while sparse literature among Nepalese population. In this study, we aim to measure the thickness of Nepalese calvarian bones and find the difference between gender and ethnic groups.Methods: This was a descriptive cross-sectional study conducted in our center during a period of 6 months. Patient of age 15 to 50 years with normal CT finding were included in the study. Using the axial view of brain CT, the thickness of cranial vault was measured and recorded in millimeter. Results: Among 100 patients, 51 were male and 49 were female. Mean thickness of frontal bone, parietal, temporal and occipital bone were 8.02±1.97 mm, 7.04±1.43 mm, 4.71±1.34 mm and 7.98±2.47 mm respectively. Conclusions: There was no significant difference in cranial vault thickness among sex or ethnical groups in patients of a hospital. Keywords: cranial vault; ethnicity; Nepalese; thickness.
Introduction: Preoperative differentiation of benign, atypical and malignant meningiomas would significantly help in surgical planning and treatment. The aim of this study is to look at radio- morphologic behavior of various histopathological types and grades of meningiomas and their diffusion characteristics.Methods: We performed an analytical cross-sectional study including all patients operated on for meningiomas at our hospital during January 2016 to July 2018. We studied 38 meningiomas in 38 patients aged 14 to 73 years old. All patients underwent MRI prior to surgery, including diffusion- weighted sequences, in a 1.5T scanner. Signal intensity in T2-weighted images, diffusion-weighted images (b=0, 90 and 1,000), and Apparent Diffusion Coefficient maps within the tumors and in the normal parietal white matter as a reference were evaluated. Results: There was female predilection with male:female ratio of 1:2.4. Most meningiomas were supratentorial with most common origin being parafalcine and convexity. Of the 38 meningiomas, 31 were WHO grade I, 6 were WHO grade II (apalstic) and one was WHO grade III (anaplastic). Similarly, tumors showing pial invasion, breached tumor-brain interface, no capsular enhancement and parenchyma invasion showed significantly low NADC. Mean ADC value was 0.722±7.7x10-3 mm2/s (normalized ADC 0.9±0.1) in the atypical group and 0.876±24.56x10-3 mm2/s (normalized ADC 1.11±0.31) in the typical group. No statistically significant differences of ADC/NADC were found between histologic subtypes. Two subtypes of typical meningiomas, metaplastic and angiomatous meningioma had the highest values in the ADC maps.Conclusions: MR morphology like pial invasion, breached tumors brain interface, parenchymal invasion can predict aggressiveness and atypical nature of meningiomas. Meningioma shows moderately restricted diffusion. The signal on the ADC map is associated with tumors cellularity and aggressiveness suggesting its usefulness for predicting the histological grade. Keywords: apparent diffusion coefficient; atypical; histopathology; meningioma; MR morphology.
Introduction: Intracranial aneurysms affect 3-8 percent of the world’s population, with rupturedaneurysms being the most common cause of subarachnoid hemorrhage. The sensitivity of ComputedTomography Angiogram in diagnosing intracranial aneurysm is 97%. The aim of our study is to findout the prevalence of ruptured intracranial aneurysms among all the admitted cases encountered inour hospital. Methods: A descriptive cross-sectional study was done at Upendra Devkota Memorial NationalInstitute of Neurological and Allied Sciences from 2016 to 2018. Convenience sampling method wasdone. In order to detect the site and size of aneurysms16 slice Siemens Computed Tomography withComputed Tomography angiogram was used. Ethical approval was obtained from the InstitutionalReview Board at Upendra Devkota Memorial National Institute of Neurological and Allied Sciences.Based on demographic data and computed tomography angiography findings, various morphometricparameters along with demographic parameters were considered for the study. Results: Among 10,856 cases, prevalence of ruptured intracranial aneurysms were found in 42(0.386%) [Confidence Interval= 0.395 to 0.377]. Among 42 cases, Middle Cerebral Artery aneurysmwas present on 16 (39.02%) followed by Anterior Communicating Artery on 14 (34.14%), thenPosterior Communicating Artery on 5 (12.19%). The largest neck and dome size were seen in basilartip aneurysm with size of 11mm and 8mm respectively. The most common type was Fischer grade 4. Conclusions: The prevalence of ruptured intracranial aneursyms were found to be higher ascompared to the other international studies.
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