Magnetic resonance imaging assessment of brainstem distortion associated with a supratentorial mass.

Inao, Suguru; Kuchiwaki, Hiroji; Kanaiwa, Hidemi; Sugito, Kazutoshi; Banno, Masakazu; Furuse, Masahiro

doi:10.1136/jnnp.56.3.280

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…This bilateral lCBF reduction in the thalamus was thought to be closely related to displacement and dysfunction in the upper brain stem (midbrain). Our previous data on the relation between the brain stem displacement and the prolongation of central conduction time on BAER also support the importance of midbrain kinking at the advanced stage of brain displacement 9. These results suggest that the mental changes in patients with CSDH were mainly disturbance in consciousness due to the dysfunction of the deep brain structures.…”

Section: Discussionsupporting

confidence: 74%

“…In our previous study,9 we demonstrated the relations among the brain displacements of the various parts of the midline structure associated with CSDH. The data indicated that the midline structures of the brain shifted and rotated when the haematoma thickness increased beyond the level of spatial compensation, and that midbrain kinking occurred in an advanced stage.…”

Section: Discussionmentioning

confidence: 87%

“…In our previous study,9 we showed the relations between brain displacement on MRI and electrophysiological changes measured by brain stem auditory evoked response (BAER) in patients with chronic subdural haematoma (CSDH). The results indicated that the latency of central conduction time was prolonged and brain stem kinking occurred when the supratentorial mass became larger.…”

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confidence: 99%

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Relation between brain displacement and local cerebral blood flow in patients with chronic subdural haematoma

Inao

2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Objectives-To evaluate the relation between brain displacement, clinical signs and symptoms, and local cerebral blood flow (lCBF) in patients with chronic subdural haematoma (CSDH). Methods-Forty five patients (age range 58-87 years, mean 71.9 (SD 8.4)) with unilateral CSDH were studied. Patients were categorised into three groups: I, headache (n=16); II, paresis (n=14); and III, mental change (n=15). T1 weighted MR images were obtained in all patients preoperatively. Quantitative values of maximum haematoma thickness, midline shift, and brain rotation angle were measured on axial and coronal MR images. In 21 patients, lCBF was measured by Xe enhanced CT. Values for lCBF were obtained in selected regions of interest in the frontal cortex, thalamus, and hemisphere on both the haematoma and contralateral sides. Results-The lCBF reduction in the ipsilateral frontal cortex showed the best linear correlation with haematoma thickness (r=0.57), whereas the reduction in the ipsilateral thalamus had the most significant correlation with pineal shift (r=0.65) and third ventricle incline (r=0.67). In patients with paresis, lCBF decreased significantly on the ipsilateral side of both the frontal cortex and thalamus (p<0.05), whereas patients with mental change showed a significant reduction of lCBF on both sides of the thalamus (p<0.01) and in the ipsilateral frontal cortex (p<0.01). Conclusions-The lCBF reduction and clinical symptoms correlated well with local brain displacement in patients with CSDH. The lCBF in the central cerebral area including the thalamus was reduced in patients with clinical signs. The mental changes found were thought to derive from mild impairment of consciousness due to upper brain stem displacement. (J Neurol Neurosurg Psychiatry 2001;71:741-746)

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 87%

mentioning

confidence: 99%

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Relation between brain displacement and local cerebral blood flow in patients with chronic subdural haematoma

Inao

2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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“…The importance of this weight‐bearing role played by the human tentorium is widely recognized in the clinical literature (e.g. Mayer, 1920; Osborn, 1977; Ropper, 1986, 1989; Inao et al. 1993; Fisher, 1995; Wijdicks & Miller, 1997).…”

Section: Introductionmentioning

confidence: 99%

Differential regional brain growth and rotation of the prenatal human tentorium cerebelli

Jeffery

2002

Journal of Anatomy

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Folds of dura mater, the falx cerebri and tentorium cerebelli, traverse the vertebrate endocranial cavity and compartmentalize the brain. Previous studies suggest that the tentorial fold has adopted an increasingly important role in supporting the increased load of the cerebrum during human evolution, brought about by encephalization and an adaptation to bipedal posture. Ontogenetic studies of the fetal tentorium suggest that its midline profile rotates inferoposteriorly towards the foramen magnum in response to disproportionate growth of the cerebrum.This study tests the hypothesis that differential growth of the cerebral and cerebellar components of the brain underlies the inferoposterior rotation of the tentorium cerebelli during human fetal development. Brain volumes and tentorial angles were taken from high-resolution magnetic resonance images of 46 human fetuses ranging from 10 to 29 gestational weeks. Apart from the expected increases of both supratentorial and infratentorial brain volumes with age, the results confirm previous studies showing a significant relative enlargement of the supratentorial volume. Correlated with this enlargement was a rotation of the midline section of the tentorium towards the posterior cranial base. These findings support the concept that increases of supratentorial volume relative to infratentorial volume affect an inferoposterior rotation of the human fetal tentorium cerebelli. These results are discussed in the context of the role played by the tentorium cerebelli during human evolution and underline implications for phylogenetic and ontogenetic models of encephalization.

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“…It has clinical importance as pressure will occur on vital structures in FM-related achondroplasia and cerebellar hernias (Inao et al, 1993;Chethan et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Magnificent Harmony in Morphometric Measurements of Orbita and Foramen Magnum

Güler

Yılmaz

2023

Int. J. Morphol.

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The foramen magnum (FM) is the key component of the craniovertebral junction, which connects the brain stem and medulla spinalis and is closely related to vital structures. FM dimensions are of great clinical importance. Considering the similarity in shape between FM and orbita, we thought that there might be a relationship between the lengths (sagittal diameter) and widths (transverse diameter) of these structures. Since it is not possible to reach FM directly, we set up our hypothesis as can we calculate the foramen magnum dimensions from orbital measurements before proceeding to costly tests. We also investigated this harmony in the skulls we used in the study. In the study, 21 dried skull bones from the Turkish population were used. FM and right Orbital length and width measurements were made. Precision digital caliper was used for measurements. Statistical validity and reliability analyzes were performed to prove the agreement between the measurements. We found that the length of the orbit and FM in the sagittal plane is close to each other, with 34.74±2.11 mm and 34.99±3.0 mm, and the width of the orbit in the coronal plane is approximately 1.40 times the width of the FM. We proved that the estimation of FM dimensions based on orbital measurements is also statistically valid and safe. Using orbital measurements, it is possible to estimate FM dimensions which are difficult to reach directly in living humans.

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Magnetic resonance imaging assessment of brainstem distortion associated with a supratentorial mass.

Cited by 8 publications

References 14 publications

Relation between brain displacement and local cerebral blood flow in patients with chronic subdural haematoma

Relation between brain displacement and local cerebral blood flow in patients with chronic subdural haematoma

Differential regional brain growth and rotation of the prenatal human tentorium cerebelli

Magnificent Harmony in Morphometric Measurements of Orbita and Foramen Magnum

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