68 results on '"Suboccipital region"'
Search Results
2. An unusual variant of the atlantomastoid muscle.
- Author
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Blackwood, N. O., Olewnik, Ł., Georgiev, G. P., Wysiadecki, G., Aysenne, A., Iwanaga, J., and Tubbs, R. S.
- Abstract
Knowledge of anatomical variations can be of use to clinicians and surgeons when, for example, viewing images of a patient or performing operations. Such knowledge can minimise the risk of iatrogenic complications. Herein, we present a case of a variant atlantomastoid muscle. The muscle was identified on the left side in an adult cadaver. The muscle's measurements and anatomical relationships are presented as well as a review of salient literature. We hope that increased knowledge of anatomical variants in the suboccipital region can improve patient care. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
3. An unusual variant of the atlantomastoid muscle
- Author
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N O Blackwood, Grzegorz Wysiadecki, Łukasz Olewnik, Aimee Aysenne, Georgi P. Georgiev, R. S. Tubbs, and Joe Iwanaga
- Subjects
Histology ,business.industry ,Suboccipital muscle ,Cadaver ,fungi ,food and beverages ,Medicine ,Anatomy ,business ,Suboccipital region ,Patient care - Abstract
Knowledge of anatomical variations can be of use to clinicians and surgeons when, for example, viewing images of a patient or performing operations. Such knowledge can minimize the risk of iatrogenic complications. Herein, we present a case of a variant atlantomastoid muscle. The muscle was identified on the left side in an adult cadaver. The muscle's measurements and anatomical relationships are presented as well as a review of salient literature. We hope that increased knowledge of anatomical variants in the suboccipital region can improve patient care.
- Published
- 2023
4. The myodural bridge complex defined as a new functional structure.
- Author
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Zheng, Nan, Chung, Beom Sun, Li, Yi-Lin, Liu, Tai-Yuan, Zhang, Lan-Xin, Ge, Yang-Yang, Wang, Nan-Xing, Zhang, Zhi-Hong, Cai, Lin, Chi, Yan-Yan, Zhang, Jian-Fei, Samuel, Okoye Chukwuemeka, Yu, Sheng-Bo, and Sui, Hong-Jin
- Subjects
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THREE-dimensional imaging , *CONNECTIVE tissues , *DURA mater , *NOTOCHORD , *THREE-dimensional modeling - Abstract
Purpose: The connective tissue between suboccipital muscles and the cervical spinal dura mater (SDM) is known as the myodural bridge (MDB). However, the adjacent relationship of the different connective tissue fibers that form the MDB remains unclear. This information will be highly useful in exploring the function of the MDB. Methods: The adjacent relationship of different connective tissue fibers of MDB was demonstrated based upon three-dimensional visualization model, P45 plastinated slices and histological sections of human MDB. Results: We found that the MDB originating from the rectus capitis posterior minor muscle (RCPmi), rectus capitis posterior major muscle (RCPma) and obliquus capitis inferior muscle (OCI) in the suboccipital region coexists. Part of the MDB fibers originate from the ventral aspect of the RCPmi and, together with that from the cranial segment of the RCPma, pass through the posterior atlanto-occipital interspace (PAOiS) and enter into the posterior aspect of the upper cervical SDM. Also, part of the MDB fibers originate from the dorsal aspect of the RCPmi, the ventral aspect of the caudal segment of the RCPma, and the ventral aspect of the medial segment of the OCI, enter the central part of the posterior atlanto-axial interspace (PAAiS) and fuse with the vertebral dura ligament (VDL), which connects with the cervical SDM. Conclusions: Our findings prove that the MDB exists as a complex structure which we termed the 'myodural bridge complex' (MDBC). In the process of head movement, tensile forces could be transferred possibly and effectively by means of the MDBC. The concept of MDBC will be beneficial in the overall exploration of the function of the MDB. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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5. Subokzipitalregion: Ergebnisse empirischer Arbeiten bezüglich lokaler Interventionen: Ein narratives Review.
- Author
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Reinhardt, René
- Abstract
Zusammenfassung Die Subokzipitalregion (SOR) stellt durch ihre hochkomplexe Vernetzung auf neurologischer, vaskulärer und biomechanischer Ebene eine Herausforderung für das Clinical Reasoning von Osteopathen dar. Es existieren unzählige Untersuchungs- und Behandlungstechniken, welche Dysfunktionen bestimmen, Kontraindikationen ausschließen und Ursache-Folge-Kette hinsichtlich des klinischen Problems bewerten sollen. So wurden jüngst diverse wissenschaftliche Untersuchungen zu den verschiedenen Wirkungen manueller Interventionen im Bereich der Subokzipitalregion durchgeführt. Dieser Artikel gibt einen Überblick über die aktuellen Forschungsergebnisse zu manuellen Techniken im Bereich der SOR und hinsichtlich deren Bedeutung im Clinical Reasoning. Die Suche erfolgte auf Pubmed, Google-Scholar und dem Osteopathic Medical Digital Repository – Ostmed.dr. Abstract The neurologic, vascular and biomechanic complexity of the suboccipital region (SOR) represents a challenge for every osteopathic clinical reasoning. There are numerous techniques to examine and treat this area and to determine somatic dysfunctions, exclude contraindications and assesses dysfunctional chains in the human body. Thus, empiric scientific research was taken in the last years to evaluate the effects of local, manual interventions. This narrative review gives an overview of results of the latest research and describes potential manual effects. Online-research was performed on Pubmed, Google-Scholar and the Osteopathic Medical Digital Repository – Ostmed.dr. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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6. The morphology of the suboccipital region in snakes, and the anatomical and functional diversity of the myodural bridge
- Author
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Bruce A. Young, Michael Cramberg, Bryson Grondel, and Skye Greer
- Subjects
integumentary system ,CSF PRESSURE ,Dura mater ,Snakes ,Anatomy ,Biology ,complex mixtures ,Apposition ,Functional diversity ,Bridge (graph theory) ,medicine.anatomical_structure ,Cerebrospinal fluid ,Neck Muscles ,Cervical Vertebrae ,medicine ,Animals ,Animal Science and Zoology ,Displacement (orthopedic surgery) ,Dura Mater ,Suboccipital region ,Neck ,Developmental Biology - Abstract
The myodural bridge, that is, skeletal muscle fibers attaching to the cervical dura mater, has been described from a variety of mammals and other amniotes. To test an earlier assumption about the presence of the myodural bridge in snakes, a comparative study was designed using a group of Colubrine snakes. Serial histological sections revealed no evidence of the myodural bridge in any of the snakes examined. Further analyses, including histology, computed tomography (CT), and micro-CT imaging of other distantly related snakes, also turned up no evidence of a myodural bridge. The close apposition of adjacent neural arches in snakes may preclude muscle tendons from passing through the intervertebral joint to reach the spinal dura. It is hypothesized that the myodural bridge functions in the clearance of the cerebrospinal fluid (CSF) by creating episodic CSF pressure pulsations, and that snakes are capable of creating equivalent CSF pressure pulsations through vertebral displacement.
- Published
- 2021
7. Anatomical Parameters of the Rectus Capitis Posterior Majorand Obliqus Capitis Inferior Muscles Based on an Oblique Sagittal Magnetic Resonance Scan Method.
- Author
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Qiang Xu, Lin Cai, Cong Liu, Ying Zhang, Samue, Okoye Chukwuemeka, Nan Zheng, Yan-Yan Chi, Sheng-Bo Yu, and Hong-Jin Sui
- Subjects
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SEXUAL dimorphism , *CONNECTIVE tissues , *MUSCLE analysis , *CEREBROSPINAL fluid , *MAGNETIC resonance imaging - Abstract
The deep suboccipital muscles has been shown to connect the spinal dura mater via dense connective tissue termed the myodural bridge (MDB). The MDB has both physiological and clinical implications. Data on morphological and imaging anatomical parameters of the deep suboccipital muscles are scare. In this study, T2-weighted images of rectus capitis posterior major (RCPma) and obliqus capitis inferior (OCI) of 109 healthy adults were obtained by 0-degree sagittal and 30-degree oblique sagittal continuous MRI scanning of the head and neck of the subjects. Sectional area parameters of the RCPma and the OCI were measured. The 0-degree sagittal section was measured with 5 mm bias from the median sagittal plane, the sectional area of the RCPma was 186.34± 55.02 mm2 on the left, and 202.35± 59.76 mm2 on the right. The sectional area of OCI was 221.72± 68.99 mm2 on the left, and 224.92± 61.34 mm2 on the right; At the section with 30-degree bias from the oblique sagittal plane, the sectional area of RCPma was 183.30± 42.24 mm2 in males, and 133.05± 26.44 mm2 in females. The sectional area of OCI was 254.81± 46.20 mm2 in males, and 167.42± 27.85 mm2 in females. Significant sex difference exists in the sectional areas of the RCPma and OCI, the values of the male subjects were predominantly larger (P < 0.05), however there were no age-related significant difference. The sectional area of RCPma is bilateral asymmetric, the RCPma on the right side is larger than that of the left side (P < 0.05), but the OCI is bilaterally symmetric (P >0.05). The MRI image features, imaging anatomical data and sexual dimorphism of the RCPma and the OCI are presented in this study. This imaging anatomical data will be useful for functional and clinical studies on the RCPma, OCI, and the MDB. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
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8. Subokzipitalregion: neurologische und vaskuläre Anatomie und Varianten.
- Author
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Reinhardt, René
- Abstract
Copyright of Osteopathische Medizin is the property of Elsevier GmbH, Urban & Fischer Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
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9. Subokzipitalregion: Entwicklung, Muskulatur und myodurale Brücken.
- Author
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Reinhardt, René
- Abstract
Zusammenfassung Hinsichtlich des Struktur-Funktions-Prinzips ist es von wesentlicher Bedeutung für Osteopathen, die genaue Anatomie und Funktionsweise des menschlichen Körpers zu kennen. Angesichts der rasant wachsenden Masse an Forschungsergebnissen scheint es zunehmend schwierig, den Überblick über relevante Informationen zu behalten. Die Subokzipitalregion (SOR) ist in Bezug auf lokale Beschwerden, Beeinflussung der Ganzkörperphysiologie und Kompensationsmechanismen für Osteopathen von großem Interesse. Der folgende Artikel beschreibt nach Recherche aktueller Publikationen die embryonale Entwicklung sowie die biomechanischen und morphologischen Erkenntnisse auf dem Gebiet der subokzipitalen Region, ihre Muskulatur und myoduralen Brücken. Diese sind hinsichtlich zervikozephaler Beschwerden und der Pumpwirkungen auf den Liquor cerebrospinalis von zunehmendem Interesse für die osteopathische Arbeit. With regard to the structure-function principle, it is essential for osteopaths to know the exact anatomy and functioning of the human body. It seems increasingly difficult to keep up to date with relevant information in view of the rapidly growing mass of research results. The suboccipital region (SOR) is of great interest for local complaints as well as for influencing whole body physiology and compensatory mechanisms in the field of osteopathy. The following article describes recent findings regarding research in the field of muscular, biomechanical, vascular and neurological structures and functions of the SOR. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
10. Anatomical Parameters of the Rectus Capitis Posterior Minor Muscle Based on a New Magnetic Resonance Scan Method.
- Author
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Qiang Xu, Cong Liu, Xiao-Ying Yuan, Yan-Yan Chi, Yun-Fei Li, Jian-Fei Zhang, Hong-Jin Sui, Seung-Ho Han, Sheng-Bo Yu, and Xiang-Tao Lin
- Subjects
- *
MAGNETIC resonance imaging , *FORMALDEHYDE , *SPINAL cord diseases , *SUBARACHNOID space , *MYCOBACTERIUM tuberculosis - Abstract
The past findings confirm that the Rectus Capitis Posterior minor (RCPmi) is connected to the cervical spinal dura mater via the Myodural Bridge (MDB) through the posterior antlanto-occipital interspace. It is hypothesized to perform some functions. Furthermore, some clinical studies found that the pathology of RCPmi might be related to chronic headaches. But few studies were related to the morphological parameters of the RCPmi. It would be conducive to performing clinical researches on the RCPmi and MDB. To explore the optimal section for measuring the RCPmi by MRI and provide imaging anatomy parameters of the RCPmi for clinical research. The RCPmi was measured in the dissection of 10 formalin-fixed cadaver specimens. The morphological parameters of the RCPmi were obtained. Based on these parameters, T2-weighted images of the RCPmi were collected from 109 healthy adults by using the MRIs with different oblique sagittal scanning angles. The parameters of length and area of the RCPmi on the scanning sections were measured using MRI workstation and Mimics software. The length of RCPmi reached a maximum at 30 degrees scanning leaned from the posterior median line through the dens of the axis in oblique sagittal section. At this scanning section, the length of RCPmi was 21.2 ± 2.6 mm in males and 19.3 ± 2.4 mm in females and the area of RCPmi was 91.9 ± 27.2 mm2 in males and 73.3 ± 22 mm2 in females. These parameters of RCPmi were present with significant gender differences (P < 0.05) but was not age related. Thirty degrees leaned from the median line was suggested to be the optimum scanning angle to display the RCPmi in oblique sagittal section. The reference values of length and area of the RCPmi were established for studies of hypertrophy or amyotrophy of the RCPmi. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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11. Author response for 'The morphology of the suboccipital region in snakes, and the anatomical and functional diversity of the myodural bridge'
- Author
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Skye Greer, Bryson Grondel, Bruce A. Young, and Michael Cramberg
- Subjects
Functional diversity ,business.industry ,Morphology (biology) ,Structural engineering ,business ,Suboccipital region ,Bridge (interpersonal) ,Geology - Published
- 2021
12. Effects of Instrumental, Manipulative and Soft Tissue Approaches for the Suboccipital Region in Subjects with Chronic Mechanical Neck Pain. A Randomized Controlled Trial
- Author
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Ana I de-la-Llave-Rincón, Juan José Arjona Retamal, Alejandro Fernández Seijo, José David Torres Cintas, and Andrea Caballero Bragado
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Upper trapezius ,Manipulation, Spinal ,medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,trigger points ,Article ,law.invention ,Randomized controlled trial ,law ,Statistical significance ,cervical pain ,suboccipital muscles ,medicine ,Humans ,Prospective Studies ,Range of Motion, Articular ,Suboccipital region ,Neck pain ,Neck Pain ,business.industry ,INYBI ,Public Health, Environmental and Occupational Health ,cervical manipulation ,Soft tissue ,Myofascial release ,Suboccipital muscle ,Physical therapy ,Medicine ,Female ,medicine.symptom ,Chronic Pain ,business - Abstract
The INYBI is an instrument used to release the suboccipital myofascial area. There is scarce evidence of its efficacy. A randomized controlled, double-blinded, longitudinal and prospective trial was performed. Ninety-six subjects (aged 29.47 ± 5.16 years) (70 women) with chronic neck pain were randomly assigned to the manual suboccipital inhibition technique (MSIT), instrumental suboccipital inhibition (INYBI) or the INYBI plus upper cervical manipulation technique (INYBI + UCMT) groups and received two sessions with a week interval between them. The Neck Disability Index was used before the first intervention and two weeks after the second intervention. Pre- and post-measurements were taken on both intervention days for pressure pain threshold of the upper trapezius and suboccipital muscles, self-perceived pain and cervical range of motion. In spite of a significant general improvement in time that was found for the three groups for all of the outcome measurements (p <, 0.05 in all cases), no between-groups differences were found (p >, 0.05 in all cases), with the exception of self-perceived pain for left rotation (p = 0.024), with the MSIT group showing the lower improvement. However, the higher degree of within-group improvements was found for the INYBI + UCMT group. It was concluded that the myofascial release therapy in the suboccipital area is effective in patients with chronic neck pain, either through a manual application or by means of the INYBI tool. Moreover, the addition of craniocervical manipulation achieved the higher within-group improvements, but with no statistical significance.
- Published
- 2021
13. Tenosynovial giant cell tumor of the suboccipital region – A rare, benign neoplasm in this location
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Corinna C. Zygourakis, Rahul Singh, Gregory W. Charville, Kristen N. Ganjoo, Martin N. Stienen, Donald E. Born, Kevin S. Kolahi, Romain Cayrol, University of Zurich, and Singh, Rahul
- Subjects
musculoskeletal diseases ,endocrine system ,Pathology ,medicine.medical_specialty ,610 Medicine & health ,Tenosynovial giant cell tumor ,10180 Clinic for Neurosurgery ,03 medical and health sciences ,2737 Physiology (medical) ,0302 clinical medicine ,Physiology (medical) ,medicine ,Neoplasm ,Giant Cell Tumors ,Benign neoplasms ,Suboccipital region ,business.industry ,General Medicine ,musculoskeletal system ,medicine.disease ,2746 Surgery ,Tendon ,2728 Neurology (clinical) ,medicine.anatomical_structure ,Neurology ,2808 Neurology ,030220 oncology & carcinogenesis ,Surgery ,Neurology (clinical) ,Presentation (obstetrics) ,business ,030217 neurology & neurosurgery - Abstract
Tenosynovial giant cell tumors (TGCTs) are benign neoplasms that arise from the synovium of tendon sheaths, bursae, and joints. We report a rare presentation of TGCT involving the suboccipital spine.
- Published
- 2020
14. Semiautomated robotic, CT-guided needle placement for postmortem CSF sampling – a novel application of the Virtobot
- Author
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Lars C. Ebert, Till Sieberth, Sabine Franckenberg, Michael J. Thali, Thomas Frauenfelder, University of Zurich, and Franckenberg, Sabine
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medicine.diagnostic_test ,business.industry ,Lumbar puncture ,10042 Clinic for Diagnostic and Interventional Radiology ,General Neuroscience ,340 Law ,2800 General Neuroscience ,610 Medicine & health ,1100 General Agricultural and Biological Sciences ,2700 General Medicine ,10218 Institute of Legal Medicine ,General Biochemistry, Genetics and Molecular Biology ,Cerebrospinal fluid ,510 Mathematics ,Virtopsy ,1300 General Biochemistry, Genetics and Molecular Biology ,medicine ,Needle placement ,Sampling (medicine) ,General Agricultural and Biological Sciences ,Nuclear medicine ,business ,Suboccipital region - Abstract
The sampling of cerebrospinal fluid (CSF) for chemical analysis is usually performed by a freehand lumbar puncture in a routine clinical procedure, while the suboccipital region is used for postmor...
- Published
- 2021
15. Scanning Electron Microscopic Observation of Myodural Bridge in the Human Suboccipital Region
- Author
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Hong-Jin Sui, Wen-Bin Jiang, Guo-Jun Ma, Nan Zheng, Zhi-Hong Zhang, Jing-Xian Sun, Shuai-Wen Ding, and Sheng-Bo Yu
- Subjects
Scanning electron microscope ,Spinal dura mater ,03 medical and health sciences ,0302 clinical medicine ,Neck Muscles ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Functional studies ,Pull force ,Suboccipital region ,030222 orthopedics ,business.industry ,Background data ,Anatomy ,Microscopic observation ,body regions ,Atlanto-Occipital Joint ,Suboccipital muscle ,Cervical Vertebrae ,Microscopy, Electron, Scanning ,Neurology (clinical) ,Dura Mater ,business ,Head ,030217 neurology & neurosurgery - Abstract
Study design A scanning electron microscopic study performed on three cadaveric specimens focused on the human suboccipital region, specifically, myodural bridge (MDB). Objective This study showed the connection form of the MDB among the suboccipital muscles, the posterior atlanto-occipital membrane (PAOM) and the spinal dura mater (SDM), and provided an ultrastructural morphological basis for the functional studies of the MDB. Summary of background data Since the myodural bridge was first discovered by Hack, researches on its morphology and functions had been progressing continuously. However, at present, research results about MDB were still limited to the gross anatomical and histological level. There was no research report showing the MDB's ultrastructural morphology and its ultrastructural connection forms between PAOM and SDM. Methods A scanning electron microscope (SEM) was used to observe the connection of myodural bridge fibers with PAOM and SDM in atlanto-occipital and atlanto-axial interspaces, and the connection forms were analyzed. Results Under the SEM, it was observed that there were clear direct connections between the suboccipital muscles and the PAOM and SDM in the atlanto-occipital and atlanto-axial spaces. These connections were myodural bridge. The fibers of the myodural bridge merged into the spinal dura mater and gradually became a superficial layer of the spinal dura mater. Conclusion MDB fibers merged into the SDM and became part of the SDM in the atlanto-occipital and atlanto-axial space. MDB could transfer tension and pulling force to the SDM effectively, during the contraction or relaxation of the suboccipital muscles. Level of evidence N/A.
- Published
- 2020
16. Development, maturation, and growth of the myodural bridge within the posterior atlanto-axial interspace in the rat.
- Author
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Lai HX, Gong J, Hack GD, Song TW, Liu B, Yu SB, Zhang JF, and Sui HJ
- Subjects
- Animals, Cervical Vertebrae anatomy & histology, Dura Mater anatomy & histology, Neck anatomy & histology, Rats, Atlanto-Axial Joint anatomy & histology, Neck Muscles anatomy & histology
- Abstract
The myodural bridge (MDB) complex are fibrous bridges that functionally connect the spinal dura mater to the suboccipital musculature. Previously, we described the maturational sequence of the MDB within the posterior atlanto-occipital interspace of the rat. The present paper describes the morphology and developmental maturation of the MDB within the posterior atlanto-axial interspace of the rat. In the present study, E18 embryonic rats, newborn rats, and adult rats were selected to evaluate the development and growth of the MDB. Within the posterior atlanto-axial interspace of the rat, the fibers of the MDB and its associated muscles, in the embryonic rat, were observed to be scarce and lightly stained. In contrast, these same structures observed in the postnatal rat were quite apparent and robustly stained. After birth, it was observed that MDB originated from the rectus capitis dorsal major muscle, extended forward and downward, and finally merged with the posterior atlanto-axial membrane. As the rats developed and matured, the observed MDB fibers passing through the posterior atlanto-axial interspace appeared denser and more organized. This study evidenced that the MDB fibers within the posterior atlanto-axial interspace were primarily composed of type I collagen fibers in the postnatal rat. By observing the suboccipital region, we are able to hypothesize that the MDB complex plays a key role in maintaining the subdural space located within the upper cervical segment during growth and development. This study provides a morphological basis for future research on the function of the MDB complex., (© 2022 Wiley Periodicals LLC.)
- Published
- 2022
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17. Course variability of the atlantic (V3) segment of vertebral artery: anatomical study with clinical implications
- Author
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Bogdan Ciszek and Maciej Ciołkowski
- Subjects
Histology ,Vertebral artery ,Foramen transversarium ,Large range ,Anatomy ,Tortuosity ,Suboccipital triangle ,Neurosurgical Procedures ,Course (navigation) ,medicine.anatomical_structure ,medicine.artery ,medicine ,Cervical Vertebrae ,Atlanto-occipital joint ,Suboccipital region ,Geology ,Vertebral Artery - Abstract
Background: The atlantic segment of vertebral artery (V3) located at the centre of the cranio-vertebral junction is known for its variability and asymmetry, and is either the target or on the way of numerous procedures in this region. The aim of the study was to visualise variability of V3 segment. Materials and methods: The V3 segment was studied in 49 specimens of the suboccipital region injected with coloured gelatine. Direct measurements were performed and probabilistic maps were created using digital photography. Results: The V3 segment has wavy course with possible lateral and significant postero-inferior expansions. In relation to the foramen transversarium the V3 reached up to 5 mm laterally, 23 mm posteriorly, 27 mm medially and up to 11 mm downward. Looking from the medial aspect the course of the V3 is less predictable compared to the lateral approach. Linear measurements and probabilistic maps revealed significant variability and large range of variation. There were 11 cases of V3 tortuosity found in studied material. Conclusions: The complex and variable spatial conformation of V3 makes individual diagnostic and preoperative approach necessary.
- Published
- 2019
18. Huge Osteoma on Suboccipital Region: A Case Report
- Author
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Hyuk-Jin Oh, Dong-Gyu Yeo, Jai-Joon Shim, Jae-Sang Oh, Seok-Mann Yoon, and Ji-Hoon Park
- Subjects
medicine.medical_specialty ,Osteoblastoma ,business.industry ,medicine ,Skull Neoplasm ,Radiology ,medicine.disease ,business ,Osteoma ,Suboccipital region - Published
- 2019
19. Distances from the Atlantal Segment of the Vertebral Artery to the Midline in Children.
- Author
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Tubbs, R. Shane, Smyth, Matthew D., Wellons III., John C., and Oakes, W. Jerry
- Subjects
- *
VERTEBRAL artery , *NEUROSURGEONS , *TOMOGRAPHY , *SOMATIC embryogenesis , *DURA mater - Abstract
There are scant data in the literature regarding distances from the midline to the suboccipital segment of the vertebral artery, and to our knowledge, none addressing this measurement in the pediatric population. This study seeks to establish age-related distances (Y) from the laterally placed vertebral artery to the midline at the level of the posterior arch of the atlas in children. Measurements from the midline to the most medial portion of the vertebral artery at the level of the posterior arch of the atlas were made in 50 children who underwent CT imaging of the cervical spine. For all left sides, Y = 12–23 mm (mean 17 mm). For all right sides, Y = 10–25 mm (mean 17.5 mm). For girls, Y = 12–16 mm (mean 12.7 mm) for left sides and Y = 12–25 mm (mean 18.5 mm) for right sides. For boys, Y = 12–20 mm (mean 16 mm) for left sides and Y = 10–21 mm (mean 16.7 mm) for right sides. We have found that the most medial portion of the vertebral artery from the midpoint of the posterior arch of the atlas for all ages was approximately 17 and 17.5 mm for left and right sides, respectively. This distance was generally less for left sides, except in the 16–19 years age group. However, as a group, this distance did not vary more than 2.8 mm between left and right sides. These data should assist the neurosurgeon who operates in the suboccipital region in children. Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2003
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20. The myodural bridge complex defined as a new functional structure
- Author
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Yan-Yan Chi, Yang-Yang Ge, Lin Cai, Nan Zheng, Tai-Yuan Liu, Yi-Lin Li, Sheng-Bo Yu, Okoye Chukwuemeka Samuel, Zhi-Hong Zhang, Hong-Jin Sui, Beom Sun Chung, Jian-Fei Zhang, Lan-Xin Zhang, and Nan-Xing Wang
- Subjects
Male ,Models, Anatomic ,Connective tissue ,Pathology and Forensic Medicine ,03 medical and health sciences ,Imaging, Three-Dimensional ,Neck Muscles ,Republic of Korea ,Photography ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Suboccipital region ,Process (anatomy) ,0303 health sciences ,Rectus capitis posterior major muscle ,Anatomy, Cross-Sectional ,business.industry ,Anatomy ,Visible Human Projects ,Rectus capitis posterior minor muscle ,Middle Aged ,medicine.anatomical_structure ,Bridge (graph theory) ,Atlanto-Occipital Joint ,030301 anatomy & morphology ,Connective Tissue ,Head Movements ,Ligament ,Surgery ,Obliquus capitis inferior muscle ,Dura Mater ,business - Abstract
The connective tissue between suboccipital muscles and the cervical spinal dura mater (SDM) is known as the myodural bridge (MDB). However, the adjacent relationship of the different connective tissue fibers that form the MDB remains unclear. This information will be highly useful in exploring the function of the MDB. The adjacent relationship of different connective tissue fibers of MDB was demonstrated based upon three-dimensional visualization model, P45 plastinated slices and histological sections of human MDB. We found that the MDB originating from the rectus capitis posterior minor muscle (RCPmi), rectus capitis posterior major muscle (RCPma) and obliquus capitis inferior muscle (OCI) in the suboccipital region coexists. Part of the MDB fibers originate from the ventral aspect of the RCPmi and, together with that from the cranial segment of the RCPma, pass through the posterior atlanto-occipital interspace (PAOiS) and enter into the posterior aspect of the upper cervical SDM. Also, part of the MDB fibers originate from the dorsal aspect of the RCPmi, the ventral aspect of the caudal segment of the RCPma, and the ventral aspect of the medial segment of the OCI, enter the central part of the posterior atlanto-axial interspace (PAAiS) and fuse with the vertebral dura ligament (VDL), which connects with the cervical SDM. Our findings prove that the MDB exists as a complex structure which we termed the ‘myodural bridge complex’ (MDBC). In the process of head movement, tensile forces could be transferred possibly and effectively by means of the MDBC. The concept of MDBC will be beneficial in the overall exploration of the function of the MDB.
- Published
- 2019
21. Primitive synovial sarcoma of suboccipital region in child
- Author
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Aikaterini Karagianni, Marios Themistocleous, Dimitrios Giakoumettis, Ploutarchos Karydakis, George Sfakianos, Andreas Mitsios, and Elias Antoniades
- Subjects
Surgical resection ,medicine.medical_specialty ,business.industry ,Case Report ,030206 dentistry ,medicine.disease ,Synovial sarcoma ,030218 nuclear medicine & medical imaging ,SSS ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Immunohistochemistry ,Surgery ,Radiology ,medicine.symptom ,Differential diagnosis ,Head and neck ,business ,Suboccipital region ,Confusion - Abstract
Synovial sarcoma (SS) most commonly affects the lower limbs of males in the third to fifth decades of life, with masses of the head and neck accounting for 3–10% of all cases, mainly as a metastatic lesion. The lack of specific symptoms and radiological features in addition to the diversity of their microscopic aspects may cause confusion in the diagnosis; hence, knowledge of the unusual locations of SSs is very important. The immunohistochemistry, and more recently the cytogenetic studies, contribute to the differential diagnosis. We report the case of a 12-year-old girl with a rare primary SS in the suboccipital region, which underwent complete surgical resection.
- Published
- 2018
22. Venous anomaly analogous to vertical embryonic positioning of the straight sinus associated with atretic cephalocele at the suboccipital region
- Author
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Takato Morioka, Satoshi O. Suzuki, Ryutaro Kira, Nobuya Murakami, and Nobuko Kawamura
- Subjects
medicine.medical_specialty ,genetic structures ,Vascular Malformations ,Cranial Sinuses ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Cerebrospinal fluid ,Atretic cephalocele ,otorhinolaryngologic diseases ,medicine ,Humans ,In patient ,Suboccipital region ,Sinus (anatomy) ,Encephalocele ,business.industry ,Infant ,General Medicine ,Anatomy ,Internal Cerebral Vein ,Tentorium ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Female ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,Straight sinus - Abstract
The coexistence of venous anomalies, such as vertical embryonic positioning of the straight sinus (VEP of SS), has been reported in patients with atretic cephalocele (AC). VEP of SS has been exclusively encountered when the AC is found above the torcular. We report a patient with suboccipital AC associated with venous anomalies analogous to VEP of SS, consisted of the Galenic venous system which did not drain into the straight sinus in the tentorium, but into the falcine sinus instead. Differences with VEP of SS in our case had no anatomical relationship between the falcine sinus and the suboccipital AC and no large cerebrospinal fluid space around the falcine sinus. A detailed neuroradiological examination was helpful for detecting these minute anomalies.
- Published
- 2016
23. A Rare Case Report on Suboccipital Region Benign Giant Osteoma
- Author
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Sunil Munakomi and Binod Bhattarai
- Subjects
medicine.medical_specialty ,business.industry ,Case Report ,medicine.disease ,lcsh:RC346-429 ,Management algorithm ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Rare case ,otorhinolaryngologic diseases ,Medicine ,030223 otorhinolaryngology ,General Agricultural and Biological Sciences ,business ,Osteoma ,Suboccipital region ,lcsh:Neurology. Diseases of the nervous system ,Sinus (anatomy) - Abstract
Herein we report a rare case of a giant suboccipital osteoma in a 55-year-old woman presenting primarily due to cosmetic issue. We discuss the management algorithm taken in the patient, highlighting excision of a potentially curable bony tumor only after ruling out its extension to the ear cavity, mastoid ear cells, transverse sinus, and the intracranial compartment.
- Published
- 2016
24. Anatomical Parameters of the Rectus Capitis Posterior Major and Obliqus Capitis Inferior Muscles Based on an Oblique Sagittal Magnetic Resonance Scan Method
- Author
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Ying Zhang, Qiang Xu, Lin Cai, Yan-Yan Chi, Cong Liu, Hong-Jin Sui, Okoye-Chukwuemeka Samuel, Nan Zheng, and Sheng-Bo Yu
- Subjects
0301 basic medicine ,03 medical and health sciences ,0302 clinical medicine ,Imaging anatomy parameters ,business.industry ,Rectus capitis posterior major (RCPma) ,Medicine ,Suboccipital region ,030101 anatomy & morphology ,Obliqus capitis inferior (OCI) ,Anatomy ,business ,030217 neurology & neurosurgery - Abstract
SUMMARY: The deep suboccipital muscles has been shown to connect the spinal dura mater via dense connective tissue termed the myodural bridge (MDB). The MDB has both physiological and clinical implications. Data on morphological and imaging anatomical parameters of the deep suboccipital muscles are scare. In this study, T2-weighted images of rectus capitis posterior major (RCPma) and obliqus capitis inferior (OCI) of 109 healthy adults were obtained by 0-degree sagittal and 30-degree oblique sagittal continuous MRI scanning of the head and neck of the subjects. Sectional area parameters of the RCPma and the OCI were measured. The 0-degree sagittal section was measured with 5 mm bias from the median sagittal plane, the sectional area of the RCPma was 186.34± 55.02 mm2 on the left, and 202.35± 59.76 mm2 on the right. The sectional area of OCI was 221.72± 68.99 mm2 on the left, and 224.92± 61.34 mm2 on the right; At the section with 30-degree bias from the oblique sagittal plane, the sectional area of RCPma was 183.30± 42.24 mm2 in males, and 133.05± 26.44 mm2 in females. The sectional area of OCI was 254.81± 46.20 mm2 in males, and 167.42± 27.85 mm2 in females. Significant sex difference exists in the sectional areas of the RCPma and OCI, the values of the male subjects were predominantly larger (P < 0.05), however there were no age- related significant difference. The sectional area of RCPma is bilateral asymmetric, the RCPma on the right side is larger than that of the left side (P < 0.05), but the OCI is bilaterally symmetric (P >0.05). The MRI image features, imaging anatomical data and sexual dimorphism of the RCPma and the OCI are presented in this study. This imaging anatomical data will be useful for functional and clinical studies on the RCPma, OCI, and the MDB.
- Published
- 2018
25. Anatomical Parameters of the Rectus Capitis Posterior Major and Obliqus Capitis Inferior Muscles Based on an Oblique Sagittal Magnetic Resonance Scan Method
- Author
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Xu, Qiang, Cai, Lin, Liu, Cong, Zhang, Ying, Samuel, Okoye-Chukwuemeka, Zheng, Nan, Chi, Yan-Yan, Yu, Sheng-Bo, and Sui, Hong-Jin
- Subjects
Región suboccipital ,Imágenes ,Imaging anatomy parameters ,Rectus capitis posterior major (RCPma) ,Músculo recto posterior mayor de la cabeza ,Suboccipital region ,Obliqus capitis inferior (OCI) ,Músculo oblicuo mayor de la cabez - Abstract
SUMMARY: The deep suboccipital muscles has been shown to connect the spinal dura mater via dense connective tissue termed the myodural bridge (MDB). The MDB has both physiological and clinical implications. Data on morphological and imaging anatomical parameters of the deep suboccipital muscles are scare. In this study, T2-weighted images of rectus capitis posterior major (RCPma) and obliqus capitis inferior (OCI) of 109 healthy adults were obtained by 0-degree sagittal and 30-degree oblique sagittal continuous MRI scanning of the head and neck of the subjects. Sectional area parameters of the RCPma and the OCI were measured. The 0-degree sagittal section was measured with 5 mm bias from the median sagittal plane, the sectional area of the RCPma was 186.34± 55.02 mm2 on the left, and 202.35± 59.76 mm2 on the right. The sectional area of OCI was 221.72± 68.99 mm2 on the left, and 224.92± 61.34 mm2 on the right; At the section with 30-degree bias from the oblique sagittal plane, the sectional area of RCPma was 183.30± 42.24 mm2 in males, and 133.05± 26.44 mm2 in females. The sectional area of OCI was 254.81± 46.20 mm2 in males, and 167.42± 27.85 mm2 in females. Significant sex difference exists in the sectional areas of the RCPma and OCI, the values of the male subjects were predominantly larger (P < 0.05), however there were no age- related significant difference. The sectional area of RCPma is bilateral asymmetric, the RCPma on the right side is larger than that of the left side (P < 0.05), but the OCI is bilaterally symmetric (P >0.05). The MRI image features, imaging anatomical data and sexual dimorphism of the RCPma and the OCI are presented in this study. This imaging anatomical data will be useful for functional and clinical studies on the RCPma, OCI, and the MDB. RESUMEN: Se ha demostrado que los músculos suboccipitales profundos conectan la duramadre espinal a través del tejido conectivo denso denominado puente miodural (PMD). El PMD tiene implicaciones tanto fisiológicas como clínicas. Los datos sobre los parámetros anatómicos y morfológicos y de imagen de los músculos suboccipitales profundos son alarmantes. En este estudio, se obtuvieron imágenes ponderadas en T2 del músculo recto posterior mayor (RCPma) y del músculo oblicuo mayor de la cabeza (OCI) de 109 adultos sanos, mediante una exploración de la cabeza y el cuello sagital de 0 grados y sagital oblicua de 30 grados. Se midieron los parámetros de área seccional del RCPma y el OCI. La sección sagital de 0 grados se midió con un sesgo de 5 mm desde el plano mediano, el área de la sección de la RCPma fue 186,34 ± 55,02 mm2 a la izquierda y 202,35 ± 59,76 mm2 a la derecha. El área seccional de OCI fue 221.72 ± 68.99 mm2 a la izquierda y 224.92 ± 61.34 mm2 a la derecha. En la sección de 30 grados desde el plano sagital oblicuo, el área de la sección de RCPma fue de 183.30 ± 42.24 mm2 en los hombres, y 133.05 ± 26.44 mm2 en las mujeres. El área seccional de OCI fue de 254.81 ± 46.20 mm2 en varones y 167.42 ± 27.85 mm2 en mujeres. Existe una diferencia significativa según el sexo en las áreas seccionales de la RCPma y la OCI, los valores de los sujetos masculinos fueron predominantemente mayores (P 0.05). Las características de la imagen de resonancia magnética, los datos anatómicos de imágenes y el dimorfismo sexual de la RCPma y la OCI se presentan en este estudio. Estos datos anatómicos de imágenes serán útiles para estudios funcionales y clínicos en RCPma, OCI y PMD.
- Published
- 2018
26. Anatomical Parameters of the Rectus Capitis Posterior Minor Muscle Based on a New Magnetic Resonance Scan Method
- Author
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Xu, Qiang, Liu, Cong, Yuan, Xiao-Ying, Chi, Yan-Yan, Li, Yun-Fei, Zhang, Jian-Fei, Sui, Hong-Jin, Han, Seung-Ho, Yu, Sheng-Bo, and Lin, Xiang-Tao
- Subjects
Región suboccipital ,Imaging anatomy parameters ,Parámetros de anatomía de imagen ,Resonancia magnética ,Músculo recto posterior menor de la cabeza ,Suboccipital region ,Rectus capitis posterior minor muscle (RCPmi) - Abstract
The past findings confirm that the Rectus Capitis Posterior minor (RCPmi) is connected to the cervical spinal dura mater via the Myodural Bridge (MDB) through the posterior antlanto-occipital interspace. It is hypothesized to perform some functions. Furthermore, some clinical studies found that the pathology of RCPmi might be related to chronic headaches. But few studies were related to the morphological parameters of the RCPmi. It would be conducive to performing clinical researches on the RCPmi and MDB. To explore the optimal section for measuring the RCPmi by MRI and provide imaging anatomy parameters of the RCPmi for clinical research. The RCPmi was measured in the dissection of 10 formalin-fixed cadaver specimens. The morphological parameters of the RCPmi were obtained. Based on these parameters, T2-weighted images of the RCPmi were collected from 109 healthy adults by using the MRIs with different oblique sagittal scanning angles. The parameters of length and area of the RCPmi on the scanning sections were measured using MRI workstation and Mimics software. The length of RCPmi reached a maximum at 30 degrees scanning leaned from the posterior median line through the dens of the axis in oblique sagittal section. At this scanning section, the length of RCPmi was 21.2 ± 2.6 mm in males and 19.3 ± 2.4 mm in females and the area of RCPmi was 91.9 ± 27.2 mm2 in males and 73.3 ± 22 mm2 in females. These parameters of RCPmi were present with significant gender differences (P < 0.05) but was not age related. Thirty degrees leaned from the median line was suggested to be the optimum scanning angle to display the RCPmi in oblique sagittal section. The reference values of length and area of the RCPmi were established for studies of hypertrophy or amyotrophy of the RCPmi. Hallazgos previos confirman que el músculo rector posterior menor de la cabeza (mRPMC) está conectado a la duramadre cervical por medio del puente miodural (PMD) a través del espacio intermedio antlanto-occipital posterior. Se plantea la hipótesis de su capacidad para realizar algunas funciones. Además, estudios clínicos encontraron que la patología del mRPMC podría estar relacionada con dolores de cabeza crónicos. Sin embargo, pocos estudios se relacionaron con los parámetros morfológicos del mRPMC. Se buscará realizar investigaciones clínicas sobre el mRPMC y el PMD, además de explorar la sección óptima que permita medir el mRPMC por resonancia magnética (RM) y que permita obtener la imagen adecuada para la identificación de los parámetros anatómicos del mRPMC en la investigación clínica. Se midió el mRPMC durante la disección de 10 especímenes, correspondientes a cadáveres fijados con formalina. Se obtuvieron los parámetros morfológicos del mRPMC. Basándose en estos parámetros, se estudiaron imágenes ponderadas en T2 del mRPMC de 109 adultos sanos, utilizando las resonancias magnéticas con diferentes ángulos de exploración sagital oblicua. Los parámetros de longitud y área del mRPMC en las secciones de exploración se midieron utilizando la estación de trabajo del equipo de RM y el software Mimics. La longitud del mRPMC alcanzó un máximo de 30 grados de exploración, inclinado desde la línea mediana posterior, a través del eje en la sección sagital oblicua. En esta sección la longitud del mRPMC fue 21,2 ± 2,6 mm en los hombres y 19,3 ± 2,4 mm en las mujeres, y el área del mRPMC fue 91,9 ± 27,2 mm2 en los hombres y 73,3 ± 22 mm2 en las mujeres. Se observaron diferencias significativas de sexo en estos parámetros del mRPMC (P
- Published
- 2017
27. Anatomical Parameters of the Rectus Capitis Posterior Minor Muscle Based on a New Magnetic Resonance Scan Method
- Author
-
Yun-Fei Li, Sheng-Bo Yu, Qiang Xu, Cong Liu, Seung-Ho Han, Xiao-Ying Yuan, Xiang-Tao Lin, Jian-Fei Zhang, Hong-Jin Sui, and Yan-Yan Chi
- Subjects
Imaging anatomy parameters ,Suboccipital region ,Rectus capitis posterior minor muscle (RCPmi) ,Anatomy - Abstract
The past findings confirm that the Rectus Capitis Posterior minor (RCPmi) is connected to the cervical spinal dura mater via the Myodural Bridge (MDB) through the posterior antlanto-occipital interspace. It is hypothesized to perform some functions. Furthermore, some clinical studies found that the pathology of RCPmi might be related to chronic headaches. But few studies were related to the morphological parameters of the RCPmi. It would be conducive to performing clinical researches on the RCPmi and MDB. To explore the optimal section for measuring the RCPmi by MRI and provide imaging anatomy parameters of the RCPmi for clinical research. The RCPmi was measured in the dissection of 10 formalin-fixed cadaver specimens. The morphological parameters of the RCPmi were obtained. Based on these parameters, T2-weighted images of the RCPmi were collected from 109 healthy adults by using the MRIs with different oblique sagittal scanning angles. The parameters of length and area of the RCPmi on the scanning sections were measured using MRI workstation and Mimics software. The length of RCPmi reached a maximum at 30 degrees scanning leaned from the posterior median line through the dens of the axis in oblique sagittal section. At this scanning section, the length of RCPmi was 21.2 ± 2.6 mm in males and 19.3 ± 2.4 mm in females and the area of RCPmi was 91.9 ± 27.2 mm2 in males and 73.3 ± 22 mm2 in females. These parameters of RCPmi were present with significant gender differences (P < 0.05) but was not age related. Thirty degrees leaned from the median line was suggested to be the optimum scanning angle to display the RCPmi in oblique sagittal section. The reference values of length and area of the RCPmi were established for studies of hypertrophy or amyotrophy of the RCPmi.
- Published
- 2017
28. A Previously Unreported Arterial Variant of the Suboccipital Region Based on Cadaveric Dissection
- Author
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Fernando Alonso, R. Shane Tubbs, Brittni Burgess, Jens R. Chapman, Rod J. Oskouian, Christian Fisahn, and Joe Iwanaga
- Subjects
0301 basic medicine ,anatomy ,Vertebral artery ,Carotid arteries ,lcsh:Surgery ,anomaly ,Case Report ,Posterior approach ,lcsh:RC346-429 ,03 medical and health sciences ,suboccipital triangle ,0302 clinical medicine ,medicine.artery ,medicine ,Suboccipital region ,lcsh:Neurology. Diseases of the nervous system ,business.industry ,carotid artery ,Anatomy ,lcsh:RD1-811 ,Suboccipital triangle ,Posterior arch ,medicine.anatomical_structure ,c1 ,Cadaveric dissection ,Surgery ,030101 anatomy & morphology ,Neurology (clinical) ,Internal carotid artery ,business ,030217 neurology & neurosurgery - Abstract
Introduction Several arterial variants have been reported to occur around the posterior arch of the atlas. Understanding the various anomalies and diagnosing them preoperatively can dramatically reduce the risk of surgical insult during neurosurgical procedures. Herein we report a case of an arterial variant found just below the posterior arch of C1. Case Report During the routine dissection of the suboccipital region via a posterior approach, an unusual bulge was identified just inferior to the inferior capitis oblique muscle. With further dissection, the structure was identified as a tortuous internal carotid artery. Conclusion Arterial variants around the posterior arch of C1 are surgically significant and can result in catastrophic injuries if unappreciated. Most of these variants will be related to the vertebral artery. To our knowledge, an arterial variant of the internal carotid artery in this location, as reported herein, has not been previously reported.
- Published
- 2017
29. The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring
- Author
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Du Jin Park, Sung Hak Cho, and Soo Han Kim
- Subjects
Straight leg raise ,Suboccipital muscle inhibition ,Self-myofascial release ,medicine.medical_specialty ,Flexibility (anatomy) ,medicine.diagnostic_test ,business.industry ,fungi ,education ,Physical Therapy, Sports Therapy and Rehabilitation ,Surgery ,Myofascial release ,medicine.anatomical_structure ,Physical medicine and rehabilitation ,Suboccipital muscle ,mental disorders ,Medicine ,Original Article ,Short hamstring ,business ,Suboccipital region ,Hamstring - Abstract
[Purpose] The purpose of this study was to research the effect of performing the suboccipital muscle inhibition (SMI) and self-myofascial release (SMFR) techniques in the suboccipital area on the flexibility of the hamstring. [Subjects] Fifty persons with short hamstrings participated in this research. According to the results of the finger-floor distance (FFD) test, the subjects were allocated to SMI and SMFR groups of 25 subjects each. [Methods] The SMI and SMFR techniques were applied to the groups. For the analysis, we used the FFD test and the straight leg raise (SLR) test for the flexibility of hamstring. The evaluator was blindfolded. [Results] In the SMI group, FFD, SLR, and PA were significantly changed after the intervention, and in the SMFR group, there was a significant change in SLR after the intervention. In a comparison between the groups, FED was found to be significantly increased in the SMI group. [Conclusion] Application of the SMI and SMFR to persons with short hamstrings resulted in immediate increases in flexibility of the hamstring. However, we could see that the SMI technique was more effective.
- Published
- 2015
30. Diagnosing Pain Referral from Neck and Shoulders
- Author
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Scott Cook and Alex J. Moule
- Subjects
Orofacial pain ,medicine.medical_specialty ,medicine.anatomical_structure ,Referral ,business.industry ,Shoulders ,Medicine ,medicine.symptom ,business ,Sternocleidomastoid muscle ,Suboccipital region ,Temporomandibular joint ,Surgery - Published
- 2016
31. The mastoid emissary vein: an anatomic study with magnetic resonance imaging
- Author
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Satoshi Tsutsumi, Yukimasa Yasumoto, and Hideo Ono
- Subjects
0301 basic medicine ,Cerebral veins ,Adult ,Gadolinium DTPA ,Male ,medicine.medical_specialty ,Adolescent ,Contrast Media ,Cranial Sinuses ,Mastoid ,Pathology and Forensic Medicine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Cadaver ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Mastoid foramen ,Suboccipital region ,Aged ,Retrospective Studies ,Sigmoid sinus ,medicine.diagnostic_test ,business.industry ,Skull ,Magnetic resonance imaging ,Middle Aged ,Cerebral Veins ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Coronal plane ,Surgery ,Female ,030101 anatomy & morphology ,Radiology ,Anatomy ,Jugular Veins ,business ,030217 neurology & neurosurgery - Abstract
The mastoid emissary vein (MEV) is a small venous channel connecting the intracranial and extracranial venous systems. Most current knowledge about the MEV has been obtained through cadaver studies. This study aimed to explore the MEV in vivo, using magnetic resonance imaging (MRI). Ninety-six patients were enrolled in this study. The initial examinations used the conventional MRI sequences; contrast examinations were performed using thin-sliced sections. The MEVs were identified bilaterally in 59.3 % of the 96 patients and unilaterally in 29.2 %. The original site, size, and intraosseous course of the MEVs were highly variable. On coronal images, the MEVs originated from a variable height on the posterior wall of the sigmoid sinus, most frequently from the lower third of the wall. Intraosseous MEV courses were classified as straight, curved, or tortuous, with the straight type occurring most frequently. The MEVs were dominant on the right side in 51.8 % of cases and on the left side in 24.7 % of cases. Two patients had two MEVs on the same side. Furthermore, on eight sides (5.6 %), the diploic venous channel was found to communicate with the MEV. The MEV is a structure with diverse morphologies and right-sided dominancy. MEVs should be evaluated before performing surgical and endovascular procedures around the suboccipital region.
- Published
- 2016
32. Suboccipital Neuralgia and Decompression
- Author
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Esther Rawner, Matthew P. Rupert, Rafael Justiz, Gabor B. Racz, and Andrea M. Trescot
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Foramen magnum ,business.industry ,Decompression ,Vertebral artery ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Occipital neuralgia ,medicine.artery ,medicine ,Neuralgia ,business ,Suboccipital region - Abstract
Because of the potentially dangerous structures in the suboccipital region (such as the foramen magnum and vertebral artery), clinicians have tended to avoid this area, despite the pathology often seen there. This chapter discusses the regional pathology, the alternative techniques, and a novel interventional approach, the “Stealth” approach, for occipital decompression.
- Published
- 2016
33. Is there any coexistence of sacroiliac joints dysfunction with dysfunctions of occipito-atlanto-axial complex? Part II: The biomechanical aspect
- Author
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Jolanta Kujawa, Tomasz Adamczewski, and Adrianna Grabowska
- Subjects
Sacroiliac joint ,business.industry ,Significant difference ,General Medicine ,Anatomy ,Low back pain ,medicine.anatomical_structure ,medicine ,In patient ,Manual therapy ,medicine.symptom ,business ,Suboccipital region ,Vertebral column ,Pelvis - Abstract
Introduction As the sacroiliac joints (SIJ) join two kinematic chains, the pelvis and the vertebral column, their functional disorders cause secondary changes in the musculoskeletal system. Other reasons concerning a connection between its distant parts are tensegrity principles that govern tension distribution in tendons, muscles, fasciae and ligaments. Our hypothesis was that due to a biomechanical connection between SIJ and cervico-cephalic joints (CCJ), dysfunctions in the SIJ can determine dysfunctions in the CCJ. Aim The aim of this study was to assess various types of SIJ dysfunctions (ilio-sacral and sacro-iliac) and their possible coexistence with CCJ dysfunctions. Materials and methods The study group comprised 80 patients with low back pain, 40 of whom were diagnosed with SIJ dysfunctions. The examination of the suboccipital region by Kaltenborn and Evjenth was conducted by a researcher who was unaware of the results of the pelvis examination. StatGraphics Centurion XV was employed for data analysis. Results and discussion CCJ dysfunctions were detected in almost all subjects. There was a statistically significant difference in mobility and in gliding of the C0–C1 segment between both groups. The restricted mobility on the left side of the C0–C1 segment was statistically significant. The detected abnormal stability on the right side of the C1 motion segment in the study group did not correlate with the side of the SIJ dysfunction. Conclusions There was no dominant dysfunction of the SIJ. The prevalence of dysfunctions of the upper cervical motion segments was high in the study group. There was a tendency towards larger numbers of dysfunctions concerning the right CCJ than the left one observed in patients with SIJ dysfunctions.
- Published
- 2012
34. Anatomic study of the suboccipital artery of Salmon with surgical significance
- Author
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Garrett D. Moore, Anthony V. D'Antoni, Fortunato Battaglia, and Anthony C. DiLandro
- Subjects
Male ,medicine.medical_specialty ,Histology ,Vertebral artery ,Atlas (anatomy) ,Cadaver ,medicine.artery ,medicine ,Humans ,Suboccipital region ,Vertebral Artery ,Aged ,Aged, 80 and over ,business.industry ,Anatomic Variation ,General Medicine ,Anatomy ,Suboccipital triangle ,Posterior arch ,Surgery ,Skull ,medicine.anatomical_structure ,Female ,business ,Artery - Abstract
The anatomy of the muscular branches of the vertebral arteries has clinical relevance during surgical procedures, suboccipital injections, and manual therapies. Each vertebral artery is divided into four segments. Segment V3, found in the suboccipital triangle, courses posteromedially around the lateral mass to lie in a groove on the posterior arch of the atlas, ultimately coursing beneath the posterior atlanto-occipital membrane to enter the skull. Although not always present, any muscular branch that emanates from this segment to supply the suboccipital muscles is called the suboccipital artery of Salmon. There is a paucity of literature on this artery despite its clinical relevancy. We found the suboccipital artery of Salmon in 10 (67%) of 15 embalmed adult cadavers. This frequency is considerably higher than that in previous reports. Two (20%) of the 10 cadavers demonstrated bilateral and symmetrical suboccipital arteries of Salmon (one artery on each side). Four (40%) of the 10 cadavers had an arrangement of two parallel suboccipital arteries of Salmon on one side, and one on the contralateral side. Three (30%) of the 10 cadavers displayed an asymmetrical unilateral arrangement (only one artery). One (10%) of the 10 cadavers displayed the unique arrangement of three arteries of Salmon on one side and one artery on the contralateral side. This study adds to a limited, but growing, body of knowledge by providing photographic evidence of the course and arrangement of these arteries and, therefore, can be of value to surgeons and other clinicians whose procedures focus on the suboccipital region.
- Published
- 2010
35. Large Cervical Paraspinal Haemangioma in Association with Intraosseous Haemangioma: A Rare Case Report
- Author
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Hanish Bansal, Anuj Mahajan, and Ashwani Chaudhary
- Subjects
intramuscular ,medicine.medical_specialty ,business.industry ,Left parotid gland ,lcsh:R ,Clinical Biochemistry ,lcsh:Medicine ,Surgery Section ,General Medicine ,Anatomy ,Surgery ,Vertebra ,body regions ,Vertebral body ,medicine.anatomical_structure ,masseter ,Rare case ,medicine ,Intramuscular haemangioma ,benign ,business ,Suboccipital region ,Subcutaneous tissue - Abstract
Haemangiomas are most commonly found in skin and subcutaneous tissue and are very rare in intramuscular region. Paraspinal musculature has been barely reported as location of intramuscular haemangioma while we could not find any literature reporting haemangioma in cervical paraspinal previously. We report a case of middle aged woman with a large intamuscular haemangioma involving left cervical paraspinal musculature extending from suboccipital region to C5 vertebra and reaching upto left parotid gland along with C6 vertebral body haemangioma.
- Published
- 2015
36. Primitive synovial sarcoma of suboccipital region in child.
- Author
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Karydakis, Ploutarchos, Mitsios, Andreas, Antoniades, Elias, Sfakianos, George, Themistocleous, Marios, Giakoumettis, Dimitrios, and Karagianni, Aikaterini
- Subjects
- *
SYNOVIOMA , *OCCIPITAL bone , *IMMUNOHISTOCHEMISTRY - Abstract
Synovial sarcoma (SS) most commonly affects the lower limbs of males in the third to fifth decades of life, with masses of the head and neck accounting for 3–10% of all cases, mainly as a metastatic lesion. The lack of specific symptoms and radiological features in addition to the diversity of their microscopic aspects may cause confusion in the diagnosis; hence, knowledge of the unusual locations of SSs is very important. The immunohistochemistry, and more recently the cytogenetic studies, contribute to the differential diagnosis. We report the case of a 12-year-old girl with a rare primary SS in the suboccipital region, which underwent complete surgical resection. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
37. Distances from the Atlantal Segment of the Vertebral Artery to the Midline in Children
- Author
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R. Shane Tubbs, John C. Wellons, Matthew D. Smyth, and W. Jerry Oakes
- Subjects
Male ,Adolescent ,Vertebral artery ,education ,Neurosurgical Procedures ,stomatognathic system ,Reference Values ,Atlas (anatomy) ,medicine.artery ,medicine ,Humans ,Cervical Atlas ,Child ,Suboccipital region ,Vertebral Artery ,Anthropometry ,business.industry ,General Medicine ,Anatomy ,body regions ,medicine.anatomical_structure ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Circulatory system ,Female ,Surgery ,Neurology (clinical) ,Tomography, X-Ray Computed ,business ,Blood vessel - Abstract
There are scant data in the literature regarding distances from the midline to the suboccipital segment of the vertebral artery, and to our knowledge, none addressing this measurement in the pediatric population. This study seeks to establish age-related distances (Y) from the laterally placed vertebral artery to the midline at the level of the posterior arch of the atlas in children. Measurements from the midline to the most medial portion of the vertebral artery at the level of the posterior arch of the atlas were made in 50 children who underwent CT imaging of the cervical spine. For all left sides, Y = 12–23 mm (mean 17 mm). For all right sides, Y = 10–25 mm (mean 17.5 mm). For girls, Y = 12–16 mm (mean 12.7 mm) for left sides and Y = 12–25 mm (mean 18.5 mm) for right sides. For boys, Y = 12–20 mm (mean 16 mm) for left sides and Y = 10–21 mm (mean 16.7 mm) for right sides. We have found that the most medial portion of the vertebral artery from the midpoint of the posterior arch of the atlas for all ages was approximately 17 and 17.5 mm for left and right sides, respectively. This distance was generally less for left sides, except in the 16–19 years age group. However, as a group, this distance did not vary more than 2.8 mm between left and right sides. These data should assist the neurosurgeon who operates in the suboccipital region in children.
- Published
- 2003
38. The second terminations of the suboccipital muscles: An assistant pivot for the To Be Named Ligament
- Author
-
Sheng-Bo Yu, Na-Na Mou, Jia-Ying Sui, Okoye Chukwuemeka Samuel, Xiao Zhang, Zhao Huang-Fu, Xiao-Ying Yuan, Seung-Ho Han, Nan Zheng, Hong-Jin Sui, Qi-Qi Zhao, and Chan Li
- Subjects
Male ,Vertebrae ,lcsh:Medicine ,Plant Science ,Plant Roots ,Chi Square Tests ,Mathematical and Statistical Techniques ,0302 clinical medicine ,Animal Cells ,Neck Muscles ,Medicine and Health Sciences ,030212 general & internal medicine ,lcsh:Science ,Musculoskeletal System ,Anatomical dissection ,Multidisciplinary ,Muscles ,Plant Anatomy ,Anatomy ,Cameras ,medicine.anatomical_structure ,Optical Equipment ,Connective Tissue ,Suboccipital muscle ,Physical Sciences ,Ligament ,Engineering and Technology ,Female ,Cellular Types ,Statistics (Mathematics) ,Research Article ,Muscle Tissue ,Equipment ,Biology ,Research and Analysis Methods ,Muscle Fibers ,03 medical and health sciences ,Tensile Strength ,Obliquus capitis inferior ,medicine ,Humans ,Statistical Methods ,Statistical Hypothesis Testing ,Suboccipital region ,Ligaments ,lcsh:R ,Biology and Life Sciences ,Cell Biology ,Neck muscles ,Spine ,Root Structure ,Biological Tissue ,Bridge (graph theory) ,Connective tissue metabolism ,lcsh:Q ,Head ,Mathematics ,Neck ,030217 neurology & neurosurgery - Abstract
In the last two decades, many studies have focused on the muscles and dense connective tissues located in the suboccipital region. Our study investigated the existence of the second terminations originating from the suboccipital muscles, and the relationship between the variable types of the To Be Named Ligament (TBNL). Anatomical dissection was performed on 35 head-neck specimens. The existence of the second terminations of the suboccipital muscles was confirmed and various types of the TBNL were observed in this study. The second terminations originated from multiple suboccipital muscles including the rectus capitis posterior minor (RCPmi), rectus capitis posterior major (RCPma) and obliquus capitis inferior (OCI) muscles, merged and terminated at the TBNL. The overall incidence of the second terminations of the suboccipital muscles was 34.29% and it varied among the various suboccipital muscle origins. 28.57% of the second terminations originated from the RCPma; 11.43% was from the RCPmi and 8.57% was from the OCI. Furthermore, there was a significant relationship between the existence of second terminations and the particular type of the TBNL. 95% of the arcuate type of the TBNL was accompanied with the second terminations which attached to their turning part, whereas only 10% of all the radiate type of the TBNL was accompanied with the second terminations. This study for the first time described the second terminations originating from multiple suboccipital muscles and demonstrated the relationship with the various types of the TBNL. We speculated that the second terminations maintain the arcuate TBNL and transfer tensile forces to the Myodural Bridge (MDB), thereby modulating the physiological functions of the MDB.
- Published
- 2017
39. Cooled radiofrequency ablation for bilateral greater occipital neuralgia
- Author
-
Akhil Chhatre and Tiffany Vu
- Subjects
medicine.medical_specialty ,Greater occipital nerve ,Pulsed radiofrequency ,Radiofrequency ablation ,business.industry ,medicine.medical_treatment ,Case Report ,medicine.disease ,Ablation ,Vertex (anatomy) ,lcsh:RC346-429 ,Surgery ,law.invention ,medicine.anatomical_structure ,Occipital neuralgia ,law ,medicine ,Radiology ,Headaches ,medicine.symptom ,General Agricultural and Biological Sciences ,business ,Suboccipital region ,lcsh:Neurology. Diseases of the nervous system - Abstract
This report describes a case of bilateral greater occipital neuralgia treated with cooled radiofrequency ablation. The case is considered in relation to a review of greater occipital neuralgia, continuous thermal and pulsed radiofrequency ablation, and current medical literature on cooled radiofrequency ablation. In this case, a 35-year-old female with a 2.5-year history of chronic suboccipital bilateral headaches, described as constant, burning, and pulsating pain that started at the suboccipital region and radiated into her vertex. She was diagnosed with bilateral greater occipital neuralgia. She underwent cooled radiofrequency ablation of bilateral greater occipital nerves with minimal side effects and 75% pain reduction. Cooled radiofrequency ablation of the greater occipital nerve in challenging cases is an alternative to pulsed and continuous RFA to alleviate pain with less side effects and potential for long-term efficacy.
- Published
- 2013
40. Schwannoma causing greater occipital nerve neuralgia: Case report
- Author
-
Arjun Dass, Amrinder Kaur, Hitesh Verma, Nitin Gupta, and Surinder K Singhal
- Subjects
suboccipital ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Greater occipital nerve ,lcsh:Surgery ,Energy Engineering and Power Technology ,Magnetic resonance imaging ,lcsh:RD1-811 ,Schwannoma ,medicine.disease ,Greater occipital nerve (Arnold nerve) ,Aspiration cytology ,Fuel Technology ,medicine.anatomical_structure ,Male patient ,medicine ,Neuralgia ,Radiology ,business ,schwannoma ,Suboccipital region ,Cervical vertebrae - Abstract
Schwannomas are benign tumors that originate from the Schwann cells of the nerve sheath. They can arise from any myelinated nerve. The pre-operative diagnosis of schwannoma is difficult and should be suggested by clinical features and supported by investigations based on techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging, and fine-needle aspiration cytology. Schawannomas can present with very subtle symptoms or morbid sequel. A 19-year-old male patient presented with 6 months history of swelling in the upper left side part of the neck. Local examination showed a 5 cm and times; 3 cm single globular mass in the left suboccipital region. The contrast enhanced CT scan showed a 44 mm and times; 46 mm and times; 39 mm well defined heterogeneous mildly enhancing mass on the left side of the upper three cervical vertebras abutting them. The mass was excised under general anesthesia by transcervical approach. After extensive search of English literature we came across only three case reports where schwannoma of greater occipital nerve presented with neuralgia. [Arch Clin Exp Surg 2016; 5(1.000): 59-62]
- Published
- 2016
41. Klippel-Feil syndrome revisited: diagnostic pitfalls impacting neurosurgical management
- Author
-
Martin C. Johnson
- Subjects
Male ,medicine.medical_specialty ,Decompression ,Neurosurgery ,Klippel–Feil syndrome ,Postoperative Complications ,medicine ,Humans ,Suboccipital region ,business.industry ,General surgery ,Infant, Newborn ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Cervicomedullary Junction ,Surgery ,Hydrocephalus ,Shunting ,Klippel-Feil Syndrome ,Pediatrics, Perinatology and Child Health ,Etiology ,Female ,Neurology (clinical) ,business - Abstract
Klippel-Feil syndrome in its most basic definition includes several anomalous conditions of the cervicomedullary junction and suboccipital region. Pediatric neurosurgeons are often involved in surgical palliation of this syndrome, without realizing how the accompanying anomalies may obfuscate management in the older child. A brief review of the embryology of the rhombencephalon helps to clarify the etiology of some of these symptoms which may cause confusion and, occasionally, inappropriate treatment. Illustrative cases will demonstrate some of these pitfalls. Appropriate early intervention, such as posterior fossa decompression, ventricular shunting, and fundal plication, may help to avoid needless morbidity. The advent of magnetic resonance scanning has helped to clarify the diagnosis and resulted in more appropriate treatment in these cases.
- Published
- 1992
42. Unusual Massive Neurinoma in the Suboccipital Region. Case Report
- Author
-
Ketan Desai, Dattatraya Muzumdar, Asha Shenoy, and Atul Goel
- Subjects
Transverse sinuses ,business.industry ,Vertebral artery ,Anatomy ,Schwannoma ,medicine.disease ,Lesion ,medicine.artery ,medicine ,Surgery ,Right sigmoid sinus ,Neurology (clinical) ,medicine.symptom ,Neurofibromatosis ,business ,Suboccipital region - Abstract
An 8-year-old boy with no evidence of von Recklinghausen’s disease presented with an unusual neurinoma manifesting as a gradually progressive swelling in the suboccipital region over 2 years. The lesion was massive and had widely eroded the posterior aspects of the atlas, axis, and suboccipital bone. The tumor had involved the dura of the sigmoid and transverse sinuses, was highly vascular, and had encased the ipsilateral vertebral artery. The tumor was almost completely resected although with considerable loss of blood through a large rent in the right sigmoid sinus. This unusual benign neurinoma most probably arose from the second cervical ganglion.
- Published
- 2000
43. A newly designed orthoses (N-type cervical orthoses)
- Author
-
Tarou Kodama, Masakuni Naruo, Takeo Nakamura, Kiyoshi Kajiura, Kouichi Sairyou, Eiichi Koyanagi, Mutuo Shiiba, and Misao Urakado
- Subjects
Orthodontics ,Mastoid process ,medicine.medical_specialty ,Cervical Disorder ,business.industry ,Radiography ,Cuff ,Physical therapy ,Medicine ,Range of motion ,business ,Suboccipital region - Abstract
Cervical orthoses is important for the postopereative treatment of the cervical disorder. A Newly designed cervical orthoses, N-type cervical orthoses, has been developed for 5 years. It is characteristic of the N-type cervical orthoses that it is supported by frontal, suboccipital region, mastoid process and thorax without supporting mandibula.The availability of the N-type cervical orthoses is as follows;1) Alignment can be changed at will by posterior adjustable dual hinge.2) It can be easily taken off because frontal solid cuff is inlaid design and truncal jacket is fixed by magic tape.3) It allows the patient to eat and talk easily because no mandibular support is necessary.4) It is lighter than other orthoses (700gr).As a result of measurement of stability with the N-type cervical orthoses by radiography and photography, range of motion was 13.2° in flexion and extension, 7.6°, in bending, 8.3° in rotation, and rate of control was, 77.4% in flexion, and extension 74.8% in bending and 87.1% in rotation.
- Published
- 1990
44. Deep Back, Vertebral Column, and Suboccipital Region
- Author
-
David A. Morton, Kurt H. Albertine, and Kerry D. Peterson
- Subjects
medicine.anatomical_structure ,medicine ,Anatomy ,Suboccipital region ,Geology ,Vertebral column - Published
- 2007
45. Myofascial trigger points in the suboccipital muscles in episodic tension-type headache
- Author
-
César Fernández-de-las-Peñas, Cristina Alonso-Blanco, María L. Cuadrado, and Juan A. Pareja
- Subjects
Adult ,Male ,medicine.medical_specialty ,animal structures ,Physical Therapy, Sports Therapy and Rehabilitation ,Neck Muscles ,Medicine ,Humans ,Suboccipital region ,Myofascial Pain Syndromes ,Physical Therapy Modalities ,Episodic tension-type headache ,Referred pain ,business.industry ,Tension-Type Headache ,General Medicine ,Control subjects ,TRP activity ,Bilateral Headache ,Treatment Outcome ,Suboccipital muscle ,Anesthesia ,Physical therapy ,Female ,medicine.symptom ,business ,Muscle contraction - Abstract
Referred pain evoked by suboccipital muscle trigger points (TrPs) spreads to the side of the head over the occipital and temporal bones and is usually perceived as bilateral headache. This paper describes the presence of referred pain from suboccipital muscle TrPs in subjects with episodic tension-type headache (ETTH) and in healthy controls. Ten patients presenting with ETTH and 10 matched controls without headache were examined by a blinded assessor for the presence of suboccipital muscle TrPs. Diagnostic criteria described by Simons and Gerwin were adapted to diagnose TrPs, i.e. presence of tenderness in the suboccipital region, referred pain evoked by maintained pressure for 10 s, and increased referred pain on muscle contraction. Six ETTH patients (60%) had active TrPs and 4 had latent TrPs (40%). On the other hand, 2 control subjects also had latent TrPs. Differences in the presence of suboccipital muscle TrPs between both groups were significant for active TrPs (P
- Published
- 2006
46. Wooden splinter in the foramen magnum
- Author
-
Ching Hsiao Cheng, Po Chou Liliang, Kuo Sheng Hung, and Tao Chen Lee
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hounsfield scale ,medicine ,Head Injuries, Penetrating ,Humans ,Spinal canal ,Foramen Magnum ,Suboccipital region ,General Environmental Science ,Neck pain ,Foramen magnum ,business.industry ,After discharge ,medicine.disease ,Foreign Bodies ,Wood ,Surgery ,Skull ,medicine.anatomical_structure ,Treatment Outcome ,General Earth and Planetary Sciences ,Foreign body ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
A 20-year-old male patient was involved in a violent conflict and a wound was inflicted upon his suboccipital region by a wooden chopstick. He was sent to our emergency room about 1 h later. He was irritable with fluent and clear speech and complaining of neck pain. On examination, he was conscious and alert. No peripheral neurological abnormalities or weakness of the extremities were noted. Lateral cervical spine and skull X-rays were unremarkable. Emergent nonenhanced computed tomography (CT) of the head and craniocervical junction was performed. The patient had no intracranial lesion. Axial CT at the level of craniocervical junction showed a linear low-density signal represented by a low Hounsfield unit (Hu) number of −68, traversing the spinal canal of the craniocervical junction, which coincided with the location of the chopstick (Fig. 1). A wooden chopstick retained in the foramen magnum was diagnosed. Prophylactic antibiotics and tetanus toxoid were administered. The patient underwent an emergency operation to remove the foreign body. A splinter of wooden chopstick in the foramen magnum was removed. A small dural penetration wound that was found intra-operatively was repaired after debridement. He was well, without neurological deficit or cerebrospinal fluid leakage 1 year after discharge.
- Published
- 2001
47. High cervical stress and apnoea
- Author
-
L.E Koch, H Biedermann, and K.-S. Saternus
- Subjects
Male ,Manipulation, Spinal ,medicine.medical_specialty ,Apnea ,Vertebral artery ,Sweating ,Sudden death ,Mechanical irritation ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,medicine ,Flushing ,Humans ,Suboccipital region ,Sudden infant death ,030222 orthopedics ,business.industry ,Infant, Newborn ,Infant ,Surgery ,Prone position ,Anesthesia ,Etiology ,Female ,medicine.symptom ,business ,Law ,030217 neurology & neurosurgery ,Sudden Infant Death - Abstract
The aim of this study was to investigate vegetative reactions in infants after mechanical irritation of the suboccipital region. The investigation is based on 199 infants who were observed while being treated with a suboccipital impulse (manual therapy). The results revealed vegetative reactions in more than half of all cases (52.8%, n = 105). The frequency of such vegetative reactions observed was at follows: flush 48.7% (n = 97), apnoea 22.1% (n = 44), hyperextension 13% (n = 26), and sweating 7.5% (n = 15). It is pointed out that approximately 25% of all the infants examined reacted by apnoea due to a mechanical irritation of the suboccipital region. This symptom was part of an extensive vegetative reaction. This method of inducing an apnoea has not yet been described; from this it follows that there are close relations to sudden infant death.
- Published
- 1998
48. Occipital Nerve Stimulation Using a Medtronic Resume II Electrode Array
- Author
-
Rodney Jones
- Subjects
business.industry ,Stimulation ,Anatomy ,Spinal cord stimulator ,Peripheral stimulation ,law.invention ,Anesthesiology and Pain Medicine ,Peripheral nerve ,law ,Anesthesia ,Occipital nerve ,Electrode array ,Medicine ,Occipital nerve stimulation ,business ,Suboccipital region - Abstract
Subcutaneous stimulation of the occipital nerve has been reported using percutaneously placed spinal cord stimulator electrodes. Occasionally, gradual loss of effectiveness has been noted possibly due to scar formation around the contacts. We report on the use of the Medtronic Resume II(R), peripheral nerve / spinal cord stimulator electrode for causing peripheral stimulation of the occipital nerve in the suboccipital region. Initial results suggest improved stimulation with lower power requirements using this larger electrode. The larger contact size might lessen the effect of scar formation and offer improved stimulation over a longer period.
- Published
- 2003
49. Bony reconstruction by reposition of bony chips in suboccipital craniectomy
- Author
-
Mainul Haque Sarkar, Raziul Haque, Forhad Hossain Chowdhury, Atul Goel, Khandkar Ali Kawsar, and Shafiqul Islam
- Subjects
Adult ,Male ,Local pain ,medicine.medical_specialty ,Adolescent ,Young Adult ,Image Processing, Computer-Assisted ,Humans ,Medicine ,Skull bone ,Orthopedic Procedures ,Sensory symptoms ,Suboccipital craniotomy ,Child ,Suboccipital region ,Aged ,Brain Neoplasms ,business.industry ,Middle Aged ,Plastic Surgery Procedures ,Magnetic Resonance Imaging ,Surgery ,Pseudomeningocele ,medicine.anatomical_structure ,Neurology ,Scalp ,Female ,Neurology (clinical) ,Tomography, X-Ray Computed ,business ,Craniotomy ,Follow-Up Studies - Abstract
In suboccipital craniectomy where the bone is not repositioned, there may be a significant cosmetic defect due to lack of skull bone in the suboccipital region. It may accompanied by sensory symptoms, including pain. To prevent any cosmetic defect and sensory symptoms we repositioned the bone chips at the craniectomy site in 42 suboccipital craniectomies before the closure of the scalp. At a mean follow-up of 22 months (range: 5-44 months), two patients complained of mild discomfort in the healed wound or of occasional local pain. One patient complained of mild itching at the site. In two patients, bone chips were accumulated at the lower part of the suboccipital craniectomy and failed to form a uniform bone cover at the operated site. In one patient, all bone chips were reabsorbed and there was no bone at the operated site. There was pseudomeningocele formation in one patient. In the rest of the cases there was satisfactory bone coverage at the operated site, both clinically and radiologically. The wound sites were aesthetically acceptable in 40 cases. Our study suggests that in the majority of cases where suboccipital craniotomy is not possible or not done, repositioning of the bone chips at the craniectomy site is associated with satisfactory aesthetic and functional outcome and formation of bone coverage at the operated site.
- Published
- 2010
50. Anatomic Relation between the Rectus Capitis Posterior Minor Muscle and the Dura Mater
- Author
-
Richard C. Hallgren, Gary D. Hack, Richard T. Koritzer, Philip E. Greenman, and Walker L. Robinson
- Subjects
Adult ,Male ,medicine.medical_specialty ,Dura mater ,Neck Muscles ,Cadaver ,medicine ,Humans ,Orthopedics and Sports Medicine ,Suboccipital region ,business.industry ,Dissection ,Anatomy ,Rectus capitis posterior minor muscle ,musculoskeletal system ,Suboccipital triangle ,Neck muscles ,Surgery ,Atlanto-Occipital Joint ,medicine.anatomical_structure ,Suboccipital muscle ,Occipital Bone ,Dura Mater ,Neurology (clinical) ,Cadaveric spasm ,business - Abstract
Anatomic study of the suboccipital region, specifically the deep muscles of the suboccipital triangle, was performed in cadaveric specimens.To observe and describe the relationship between the deep suboccipital musculature and the spinal dura.A review of the literature revealed no reports describing a physical connection between suboccipital musculature and the spinal dura.Dissections of the suboccipital region were performed in 10 embalmed and one fresh sagittally hemisected head and neck specimens.A connective tissue bridge between the rectus capitis posterior minor muscle and the dorsal spinal dura at the atlanto-occipital junction was observed in every specimen. The fibers of the connective tissue bridge were oriented primarily perpendicular to the dura. This arrangement of fibers appears to resist movement of the dura toward the spinal cord.Awareness of the physical relation between the rectus capitis posterior minor muscle and spinal dura via this connective tissue bridge should lessen the potential risk of dural damage during surgery. This connective tissue bridge may help resist dural infolding during head and neck extension.
- Published
- 1995
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