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The retropharyngeal space is a virtual space behind the pharynx, which extends from the scull base to the level of the fourth thoracic vertebra. Many retropharyngeal masses can cause dysphagia or airway obstruction. We report the case of a 69 year-old woman with a much enlarged aneurysm in the extracranial portion of the left internal carotid, causing dysphagia, and a short review of the relevant literature. (Folia Morphol 2010; 69, 4: 267–270)
Neurosurgical procedures in the region of the petroclival region of the skull base require unique knowledge of the local anatomy. The measurements of this region considering the visible anatomical landmarks are helpful both during surgery and while planning the general schemes for the approach. We have evaluated the anatomy of the anterior surface of the petrous bone and of the middle fossa taking into consideration the surgical removal of part of the petrous bone — the anterior petrosectomy. We have measured the distances and angles between the chosen structures in this region. The measurements were taken on 10 skulls, on both sides. The results enrich the algorithm of the anterior petrosectomy.
An accessory middle cerebral artery is one variation of the intracranial vasculature that may be a source of misinterpretation by clinicians dealing with cerebrovascular diseases. We report a case of an elderly female found to have bilateral accessory middle cerebral arteries, who presented with the rupture of an aneurysm of the anterior part of the circle of Willis. Accessory middle cerebral arteries are rare anatomical findings and the bilateral occurrence is exceedingly rare. We believe this to be the first report of bilateral accessory middle cerebral arteries associated with an aneurysm of the anterior cerebral-anterior communicating arteries. The anatomical and clinical relevance of this variation is described.
Introduction. Despite a wide range of imaging modalities available today, clinically silent osteolytic changes in the skeletal system occurring in children are still a diagnostic challenge. Case report. The study presents the case of 10-year-old girl with a tumour in a thoracic vertebra. The patient was admitted to the Paediatric Orthopedics Clinic in the Paediatric Clinical Hospital in Lublin suffering from severe pain in the thoracic and lumbar spine. The pain had started suddenly. Physical examination showed lumbar spine pain and a forced scoliotic position. To reduce the symptoms, spinal traction, analgetics and myorelaxing drugs were used. X-ray and CT of the spine showed congenital unfused S1-S3 vertebrae. An MRI was scheduled for further diagnosis. After treatment, the symptoms disappeared and the the patient was discharged after 6 days. MRI showed an oval, well-demarcated lesion in the vertebra body and left side of the arch of the Th10 vertebra. The patient was admitted to the Clinic one again. CT scan of the thoracic spine showed an osteolytic lesion in Th10 vertebra. In the spine X-ray irregular vertebral body contour in Th10 vertebra, was seen. There were no signs of neoplastic infiltration. Scintigraphy showed increased radioisotope uptake in spinal processes of Th10 and Th11 vertebrae, which confirmed the MRI results. A transpendicular trepanobiopsy of the Th10 vertebrae was performed to provide material for histopathological examination. Then, a transpedicular stabilization of Th9-Th11 vertebrae and posterior sponylodesis with spinal autografts was performed. Histopathological examination showed no malignant cells but did not help to establish a diagnosis. Conclusion. In spite of using all the available diagnostic methods it was impossible to determine the type of lesion in the patient’s spine. Genetic tumour marker test can be considered.
Quadricuspid pulmonary valve (QPV) is an uncommon congenital defect reported in the general population with a frequency of up to 0.25%. The defect usually does not cause severe clinical complications and its presence frequently remains clinically silent. Moreover, there are several difficulties in visualization of pulmonary valve using basic diagnostic modalities such as echocardiography. Therefore, in the majority of cases, QPV is detected accidentally during cardiac procedures or post mortem. The authors present a case of QPV complicated with aneurysm of the pulmonary trunk, diagnosed with computed tomography in 70-year-old woman. Although the patient had undergone transthoracic echocardiography examinations several times in the past, only computed tomography allowed the detection of the anomalous valve. In addition, the examination confirmed aneurysm of the pulmonary trunk. To the best of our knowledge, this is the first case of QPV diagnosed in vivo with computed tomography. (Folia Morphol 2009; 68, 4: 290–293)
The walls of human abdominal aortas and atherosclerosis-induced aneurysms contain similar amounts of collagen. The quantitative ratio between collagens of various types of this protein does not differ significantly either, whereas solubility of the collagen in aneurysmal wall and its susceptibility to the action of EDTA are distinctly decreased. In contrast with collagen, the amount of elastin in aneurysms is significantly lower. Total amount of glycosaminoglycans slightly decreased as compared with that of normal tissue, but the ratio of particular compounds varies. The percentage of chondroitin sulphate is increased and that of heparan sulphate significantly decreased. The significance of these changes in pathogenesis of aneurysms is discussed.
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