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1

Trigeminal neuralgia caused by aneurysm of the posterior cerebral artery: a case description and the analysis of anatomical variety of vascular complex in the rood entry zone of trigeminal nerve

100%
Dzierzanowski J., Słoniewski P.
Folia Morphologica
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2014
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tom 73
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nr 2
Trigeminal neuralgia is still a riddle, especially in the pathophysiology of the tic douloureux, although the problem has been described in many medical publications. The major theory of pain based on the compression of the Vth nerve by tumours or vessels in the rood entry zone (REZ) does not explain the facial pain in patient without neurovascular conflict, with multiple sclerosis or with conflict in places other than REZ. We report a case of the posterior cerebral artery aneurysm, which caused the isolated trigeminal neuralgia in a 48-year-old woman. She was operated on through microvascular decompression and the aneurysm was wrapped. In the second part of this study we review morphological variations of the neurovascular conflict on the basis of anatomical publications. (Folia Morphol 2014; 73, 2: 224–228)
2

Future of the nerve fibres imaging: tractography application and development directions

81%
Krakowiak M., Sloniewski P., Dzierzanowski J., Szmuda T.
Folia Morphologica
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2015
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tom 74
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nr 3
Tractography is a tool available in a growing number of centres, to enable planning of neurosurgical interventions. This method has some drawbacks and due to its increasing availability is causing a growing controversy over the possibility of an anatomical mapping of the nerve fibres. This article aims at summarising the application of the diffusion magnetic resonance in contemporary neurosurgery method, showing the usefulness and merits of its performance before surgical procedures, limitation of its application and recommendations for its improvement and more effective use for diagnostic purposes. (Folia Morphol 2015; 74, 3: 290–294)
3

Neurosurgical stereomorphometry in vivo - method description and error measurement

80%
Zielinski P., Dzierzanowski J., Sloniewski P.
Folia Morphologica
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2003
|
tom 62
|
nr 1
Rules of geometry and stereomorphometry are often applied to narrow and deep neurosurgical approaches. Methods of research are based on the direct cadaver measurements, radiological analysis and intraoperative measurements. Newly developed devices allow direct morphometry to be performed in vivo, during the operation. We describe the use of the neuronavigation system Stealth Station by Medtronic for such stereomorphometric measurements and evaluate the precision of the described method.
4

Kolejka po plaskim

80%
Dzierzanowski J.
Trybuna Leśnika
|
2002
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nr 02
11
5

The posterior communicating artery: morphometric study in 3D angio-computed tomography reconstruction. The proof of the mathematical definition of the hypoplasia

61%
Dzierzanowski J., Szarmach A., Sloniewski P., Czapiewski P., Piskunowicz M., Bandurski T., Szmuda T.
Folia Morphologica
|
2014
|
tom 73
|
nr 3
Background: The aim of this study was to investigate the morphometry of the posterior communicating artery (PCoA), on the basis of angio-computed tomography (CT), and to give proof of the mathematical definition of the term “hypoplasia of the PCoA“. Materials and methods: One hundred 3-dimensional (3D) angio-CT images, performed in adult patients with bilateral reconstruction of the PCoA (200 results) were used to calculate the morphometry of the vessel. Results: The average length of the vessel on the right side was 14.48 ± 3.47 mm, and on the left side 14.98 ± 4.77 mm (in women 14.75 mm, in men 14.70 mm). The mean of the diameter at the “proximal” point (the junction with P1) on the right side was 1.49 ± 0.51 mm, and on the left 1.46 ± 0.47 mm (in women 1.44 mm and in men 1.51 mm). The mean of the diameter in the “distal” part (the connection with ICA) on the right side was 1.4 ± 0.49 mm, and on the left 1.37 ± 0.41 mm (in women 1.38 mm, and in men 1.39 mm). No statistical correlation between the length and the diameter of the PCoA in relation to the sex and side was shown. On the basis of our measurements, we defined the hypoplasia of the artery as the estimated value less than the average diameter minus the standard deviation. The percentage distribution was as follows: the left artery 15.5%, the right artery 24%, women 11.5%, and the men 9%. Similarly to the above parameters, we have not found any statistical differences. The presence of the foetal origin was noted in 25% of the radiological examinations. The infundibular widening was visualised in 11.5% of cases of 3D reconstructions. The agenesis of PCoA was found in 9% (never bilaterally), and in 1 case the unilateral duplication of the artery was observed. No statistical differences between those parameters in relation to sex and the examined side were revealed. Conclusions: Morphological calculation of the PCoA on the basis of angio-CT from adult patients did not show any statistical differences depending on sex or the investigated side. The presented method of the calculations proved to be useful for the mathematical definition of the term “hypoplasia of the PCoA”. (Folia Morphol 2014; 73, 3: 286–291)
6

Frontal aslant tract projections to the inferior frontal gyrus

51%
Szmuda T., Rogowska M., Sloniewski P., Abuhaimed A., Szmuda M., Springer J., Sabisz A., Dzierzanowski J., Starzynska A., Przewozny T.
Folia Morphologica
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2017
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tom 76
|
nr 4
Background: Frontal aslant tract (FAT) is a white matter bundle connecting the pre-supplementary motor area (pre-SMA) and the supplementary motor area (SMA) with the inferior frontal gyrus (IFG). The purpose of the present study was to evaluate the anatomical variability of FAT. Materials and methods: Total number of fibres and the lateralisation index (LI) were calculated. We attempted to find factors contributing to the diversity of FAT regarding IFG terminations to the pars opercularis (IFG-Op) and to the pars triangularis (IFG-Tr). Magnetic resonance imaging of adult patients with diffusion tensor imaging (DTI) with total number of 98 hemispheres composed a cohort. V-shaped operculum was the most common (60.5%). Results: Total number of FAT fibres had widespread and unimodal distribution (6 to 1765; median: 160). Left lateralisation was noted in 64.3% of cases and was positively correlated with total number of FAT fibres and the bundle projecting to IFG-Op (p < 0.01). LI correlated with total number of FAT fibres (r = 0.43, p < 0.01). FAT projected predominantly to IFG-Op (88.9%; 88 of 99). Only in 3 (3.1%) cases more fibres terminated in IFG-Tr than in IFG-Op. Total number of FAT fibres and number of fibres terminating at IFG-Op did not correlate with the ratio of fibre numbers: FAT/IFG-Op, FAT/IFG-Tr and IFG-Op/IFG-Tr (p > 0.05). The greater total number of fibres to IFG-Tr was, the higher were the ratios of IFG-Tr/ /FAT (r = 0.57, p < 0.01) and IFG-Tr/IFG-Op (r = 0.32, p = 0.04). Conclusions: Among the IFG, the major termination of FAT is IFG-Op. Whereas the IFG-Tr projection seems to be related to the expansion of the entire FAT bundle regardless of side, domination and handedness. Nevertheless, FAT features a significant anatomical variability which cannot be explained in terms of DTI findings. (Folia Morphol 2017; 76, 4: 574–581)
7

Morphometric evaluation of the delayed cerebral arteries response to acetazolamide test in patients with chronic carotid artery stenosis using computed tomography angiography

51%
Szarmach A., Winklewski P. J., Halena G., Kaszubowski M., Dzierzanowski J., Piskunowicz M., Szurowska E., Frydrychowski A. F.
Folia Morphologica
|
2017
|
tom 76
|
nr 1
Background: The evidence accumulates that the response to acetazolamide test is delayed on the ipsilateral side to stenosis. However, the effect of acetazolamide beyond 30 min after acetazolamide administration remains unknown. The aim of this study was to assess the diameters of anterior cerebral arteries (ACAs), middle cerebral arteries (MCAs) and posterior cerebral arteries (PCAs) before and 60 min after the acetazolamide test. Materials and methods: Seventeen patients with carotid artery stenosis ≥ 90% on the ipsilateral side and ≤ 50% on the contralateral side were enrolled into the study. Diagnosis was based on ultrasonography examination and was confirmed using digital subtractive angiography. In all patients, two computed tomography angiography examinations were carried out; the first was performed before the acetazolamide administration, while the second one was carried out 60 min after injections. Results: In response to the acetazolamide test: PCA diameter diminished in both ipsi- and contra-lateral side to stenosis (from 1.31 to 1.24 mm and from 1.23 to 1.15 mm, respectively), ACA and MCA decreased in the contralateral side to the stenosis (from 1.33 to 1.26 mm and from 2.75 to 2.66 mm, respectively), ACA and MCA increased in the ipsilateral side to the stenosis (from 1.29 to 1.46 mm and from 2.77 to 2.96 mm, respectively). All changes were statistically significant. Conclusions: There were significant differences in reactivity to acetazolamide challenge between the internal carotid artery (ICA) and vertebrobasilar circulation in patients suffering from chronic carotid artery stenosis. Within the ICA territory, ACA and MCA responses vary in the affected and not affected side. (Folia Morphol 2017; 76, 1: 10–14)
8

Regional resting state perfusion variability and delayed cerebrovascular uniform reactivity in subjects with chronic carotid artery stenosis

51%
Szarmach A., Kaszubowski M., Sabisz A., Frydrychowski A. F., Halena G., Piskunowicz M., Dzierzanowski J., Studniarek M., Szurowska E., Winklewski P. J.
Acta Biochimica Polonica
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2018
|
tom 65
|
nr 1
9

Computed tomography indicators of cerebral microperfusion improve long term after carotid stenting in symptomatic patients

51%
Winklewski P. J., Kaszubowski M., Halena G., Sabisz A., Chwojnicki K., Dzierzanowski J., Piskunowicz M., Kurhaluk N., Szurowska E., Szarmach A.
Acta Biochimica Polonica
|
2019
|
tom 66
|
nr 2
10

Intracranial region of the vertebral artery: morphometric study in the context of clinical usefulness

42%
Dzierzanowski J., Szarmach A., Bascik B., Czapiewski P., Muc A., Piskunowicz M., Krakowiak M., Szmuda T., Sloniewski P., Szurowska E., Winklewski P. J.
Folia Morphologica
|
2017
|
tom 76
|
nr 3
Background: The aim of this study was to analyse the morphometry of the intracranial segment of the vertebral artery in the context of clinical usefulness. The results were compared with published data available in full-text archived medical journals. Materials and methods: More than 100 digital subtraction angiography (DSA) and 3-dimensional (3D) angio-computed tomography (CT) examinations were used to measure the following parameters: the whole and partial length of V₄ in characteristic anatomical points, the diameter in three places (on the level of foramen magnum, in point of exit to the posterior inferior cerebellar artery, and in the vertebro-basilar junction), the angle of connection to the vertebral arteries, and all anatomical variations including fenestration, duplication, dolichoectasia or absent artery. Results: The left V₄ section was predominant over the right artery, which is manifested by length, width, cases of ectasia and fewer cases of hypoplasia. The incidences of V₄ ectasia were identified more often than those documented in the accessible literature, and they were found in the natural location of formation of saccular aneurysms. Conclusions: The presented knowledge of anatomical variation and abnormalities of vertebral circulation can improve the accuracy and “safety” of the surgical procedures in this region, help to determine the range of surgical approach and avoid associated complications. The radiological examinations using 3D CT, DSA reveal unlimited observation of anatomical structures in contrast to studies based on cadavers, and can complement the morphometry in anatomical preparations. (Folia Morphol 2017; 76, 3: 379–387)
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