SEARCH · PubMed Health

Results for “FORAMEN”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources

PubMed1996

Herniation through the foramen of Winslow. Report of two cases.

PURPOSE: Two clinical cases of internal herniation through the foramen of Winslow are presented. The first case concerns herniation of the cecum and ascending colon. In the second patient, the ileum was herniated through the foramen epiploicum. METHODS: Preoperative assessment of clinical and radiologic findings suggested diagnosis. RESULTS: Final diagnosis was only made at laparotomy. Reduction of hernia could be performed by pulse traction, and no signs of intestinal necrosis were seen. CONCLUSION: Herniation through the foramen of Winslow should be taken into account when making a differential diagnosis for upper gastrointestinal tract obstruction.

Adult↗

PubMed1993

Visualization of patent foramen ovale by biplanar transesophageal echocardiography.

It is difficult for conventional transthoracic echocardiography (TTE), by which precise and accurate images of interatrial septum (IAS) can not be acquired, to diagnose patent foramen ovale (PFO) clearly. To evaluate the diagnostic value of biplanar transesophageal echocardiography (TEE) for PFO, TTE and biplanar TEE were performed simultaneously in 270 patients. It was found that in 7 patients patent foramen ovale was detected only through longitudinal planes of biplanar TEE. IAS, which consists of primitive septum and membrane of fossa ovalis, can be directly visualized by two-dimensional images of TEE; in patients with PFO, a dull color flow, which shunts from the right atria to the left atria through the gap between primitive septum and fossa ovalis, can be detected by color Doppler flow images. Furthermore, some right-to-left shunting microbubbles through the valve of patent fossa ovalis can be discovered by cardiac acoustic contrast echocardiography. In conclusion, biplanar TEE combined with color Doppler image and cardiac acoustic contrast facilitates a definite diagnosis of patent foramen ovale as the excellent anatomic images of IAS can be obtained from multiple views under this kind of performance.

Adult↗

PubMed2004

A new guidance device facilitates percutaneous puncture of the foramen ovale in human cadavers.

PURPOSE: Trigeminal neuralgia is the most common neurological cause for facial pain. Contemporary interventional treatment relies on surgical microvascular decompression or, alternatively, percutaneous interventions targeting the semilunar ganglion via the foramen ovale. For the latter approach, only free-hand punctures using fluoroscopy devices have been reported. Therefore, the present study aimed to evaluate a new fluoroscopy-based guidance device for transforaminal puncture. METHODS: Two experienced examiners punctured the foramen ovale bilaterally free-hand, and using a guidance device in human cadavers (n = 9). The number of attempts for puncture was recorded. A new attempt was counted each time the needle had to be retracted for redirection. RESULTS: As compared to the free-hand puncture of the foramen ovale (4.44 +/- 2.79), the new guidance device significantly reduced the number of trials needed (1.37 +/- 0.69). CONCLUSION: The employment of a guidance device facilitated percutaneous transforaminal puncture and resulted in a significantly decreased number of puncture attempts as compared to free-hand techniques in human cadavers.

Cadaver↗

PubMed2001

[The effect of volume status of the right-left shunt in a patient with a patent foramen ovale].

This is a description of the anaesthetic management of a patient with a flow patent foramen ovale undergoing intramedullary nailing of the femur. In order to detect the flow patent foramen ovale, we used transoesophageal echocardiography. During the ventilation maneuver with positive airway pressure of 20 cmH2O, a right-to-left interatrial shunt was observed. After the administration of 500 ml hydroxy-starch solution (6%) intravenously, detection of the right-to-left shunt flow was no longer possible. This case report shows that the volume status in a patient with a patent foramen ovale could influence the right to left interatrial shunt during general anaesthesia.

Anesthesia, General↗

PubMed2002

Longitudinal stress fracture: patterns of edema and the importance of the nutrient foramen.

DESIGN AND PATIENTS: We reviewed the MR appearances of six cases of longitudinal stress fracture of the lower extremity. RESULTS: One fracture was in the femur and five were in the tibia. Four of the tibial fractures showed edema starting in the mid-tibia at the level of the nutrient foramen with the fracture on the anteromedial cortex. The other tibial fracture started at the nutrient foramen. Three fractures (two tibial and the femur fracture) showed eccentric marrow edema; all fractures showed either eccentric periosteal reaction or soft tissue edema. CONCLUSION: Primary diagnosis of longitudinal stress fracture is made by finding a vertical cleft on one or more axial images. Secondary signs of position of the nutrient foramen and patterns of edema may be useful.

Adolescent↗

PubMed2005

Clinical and radiologic evaluation of foramen of Morgagni hernias and the transthoracic approach.

The limited number of publications on repair of the foramen of Morgagni hernia concentrates mainly on the laparotomy approach. We present our experience with the transthoracic approach. Patients who were diagnosed as having a foramen of Morgagni hernia and were operated on via the transthoracic approach between December 1991 and June 2004 are reviewed retrospectively for their age, sex, presenting symptoms, and diagnostic and surgical procedures. Surgical repair was carried out via the transthoracic approach in all cases. Of the 24 patients who underwent transthoracic diaphragmatic repair of the defect, 16 were women and 8 were men, with an overall mean age of 55.1 years (range 42-69 years). In most cases the defect was on the right side; there was only one case of a left-sided defect. The most common presenting symptoms were dyspnea and gastrointestinal discomfort; five (20.8%) patients were asymptomatic. In 21 cases (87.5%) the diagnoses were established radiologically. The defect was accessed surgically via a posterolateral thoracotomy. No postoperative morbidity or mortality was observed. The mean follow-up was 8.3 years (14 months to 14 years), and no recurrence was noted. As important as the surgical repair of the foramen of Morgagni hernia itself is selection of the surgical approach so adhesions of the hernial sac from the surrounding tissues in the thoracic cavity are easily released. The transthoracic approach is amenable to safe primary repair of the defect and the release of adhesions, even in elderly and obese patients, in whom adhesions may be excessive.

Adult↗

PubMed2002

Anatomical bases of superior gluteal nerve entrapment syndrome in the suprapiriformis foramen.

Observation of a 60 year-old-man with superior gluteal nerve (SGN) entrapment neuropathy in the suprapiriformis foramen encouraged us to explore, through anatomical dissection, the possible morphological etiologies of this condition. Ten SGNs in five embalmed cadavers were dissected via gluteal and pelvic access. The origin, course and distribution of the nervous trunk and its relations were studied. In most cases, the nerve fibers of the SGN arose from ventral branches of L4, L5 and S1 to constitute the nervous trunk in the pelvis, then reached the gluteal area and divided into two branches, cranial and caudal. By running through the suprapiriformis foramen with the cranial gluteal vascular pedicle, the nervous trunk was always up between the superior edge of the piriformis muscle and the greater sciatic notch; rarely some of the nerve fibers went through the muscle. Bone, muscular and vascular morphological factors liable to cause SGN entrapment syndrome, and the circumstances of discovery, were analyzed. The role of hypertrophy of the piriformis muscle, resulting in a narrow suprapiriformis foramen, was confirmed through surgery.

Aged↗

PubMed2005

Anatomy of greater palatine foramen and canal and pterygopalatine fossa in Thais: considerations for maxillary nerve block.

This study aims to investigate the anatomy of the greater palatine foramen (GPF), greater palatine canal (GPC) and pterygopalatine fossa (PPF) with special reference to the blockage of the maxillary nerve. A correlation between the length of GPC and PPF and the heights of the orbit and the maxilla was also studied using simple linear regression analysis. The morphology of the GPF, GPC and PPF as well as heights of the orbit and the maxilla were assessed in 105 Thai skulls. The thickness of the mucosa over the GPF was also measured from the dissection of 55 cadavers. The results showed that most GPF appeared as an oval foramen located at the palatal aspect of the upper third molar. The GPF was 16.2+/-1.3 mm lateral to the median sagittal plane of the hard palate, 2.1+/-1.3 mm anterior to the posterior border of the hard palate and 5.1+/-1.3 mm from the greatest concavity of the distolateral margin of the hard palate. The mean length of GPC and PPF was 29.7+/-4.2 mm. The mean angles of the GPC in relation to the hard palate and the vertical plane were 57.9+/-5.8 degrees and 6.7+/-5.2 degrees , respectively. In attempting to insert a needle to reach the foramen rotundum through the GPF, 31.7% passed into the orbit while 8.7% passed into the brain. The mean thickness of the mucosa over GPF was 6.7+/-2.3 mm. Two models for estimating the depth of needle injection in maxillary nerve block have been developed as follows: Length of GPC and PPF=19.038+0.314 (orbital height) and length of GPC and PPF=21.204+0.187 (maxillary height). The calculated length combined with the mucosal thickness was the estimated depth of needle injection. In conclusion, our results concerning the GPF, GPC and PPF will provide the useful reference for clinicians to anesthetize the maxillary nerve with a greater degree of success.

Adolescent↗

PubMed2002

Precocial diving and patent foramen ovale in bearded seal (Erignathus barbatus) pups.

In this study we used a Doppler ultrasonic device, in combination with a sonographic contrast medium, to test whether free-living bearded seal (Erignathus barbatus) pups have a closed (anatomically or functionally) foramen ovale. A total of 17 examinations were performed on 12 individual pups with a body mass range of 29-103 kg (0-21 days old). These examinations showed that young bearded seal pups dive with a patent foramen ovale (PFO), and that this structure starts to close, at least functionally, during the 2nd week of life. The wide range in the timing of closure (one animal 21 days old still had a PFO) indicates that a closed foramen ovale is not crucial for the diving that these seals perform at this age. The primary function of diving during the 1st week of life is to avoid surface predation and only moderate diving ability is sufficient to achieve this goal. However, some of the diving performed by bearded seal pups with a PFO would likely be sufficient to create intravenous bubble formation during breath-hold diving in humans. Special adaptations in the seals, such as collapsible lungs and diving with minimal lung air volume, probably prevent this from happening.

Animals↗

PubMed2004

[Platypnea-orthodeoxia of a 69-year old woman with a patent foramen ovale].

Platypnea-orthodeoxia is a rare syndrome that is often associated with interatrial shunting through a patent foramen ovale (PFO) or atrial septal defect. We describe the case of a 69-year-old woman with progressive dyspnea and hypoxia when standing, which was relieved by assuming the recumbent position. After detection of a PFO by transesophageal echocardiography the diagnosis was confirmed by transthoracic echocardiography using saline contrast injection while lying supine and standing upright. This maneuver demonstrated a large right-to-left shunt through a patent foramen ovale while the patient was in a upright position and no significant shunt while being in a recumbent position. The patient showed a rapid improvement after closure of the PFO. This case demonstrates that platypnea-orthodeoxia caused by a patent foramen ovale can be easily demonstrated by the technique of contrast transthoracic echocardiography and a simple positioning maneuver.

Aged↗

PubMed2006

Massive pulmonary embolism complicated by a patent foramen ovale with straddling thrombus: report of a case.

We report a case of massive right pulmonary embolism with a patent foramen ovale and straddling thrombus, occurring a few days after cesarean section in a 31-year-old woman. Preoperatively, a mass was seen echocardiographically in four cardiac cavities. We performed emergency surgery because of the patient's acute hemodynamic deterioration. Intraoperatively, we found a thrombus entrapped in the patent foramen ovale. Most of the thrombus was floating in the right atrium and a long end was found in the left atrium, in addition to the pulmonary emboli. We removed the thrombus, closed the patent foramen ovale by direct suturing, and performed pulmonary embolectomy. Histological examination confirmed thrombi. Doppler examination of the venous system did not reveal any possible source of the thrombus. The patient is now well and free from recurrence of embolic disease 1 year after surgery. We review the literature on this relatively unusual thromboembolic disease.

Adult↗

PubMed1982

Positive contrast echocardiography in patients with patent foramen ovale and normal right heart hemodynamics.

Peripheral M mode contrast echocardiograms were performed at rest and during the Valsalva maneuver in 11 patients with patent foramen ovale and normal right heart pressures documented by catheterization studies. Positive contrast studies (at least five clearly identifiable contrast echoes appearing in the left heart) were obtained in three patients (27 percent at rest) in six (54 percent) during the Valsalva maneuver and in seven patients (64 percent) either at rest or during the Valsalva maneuver. It is concluded that contrast echocardiography offers an opportunity to diagnose a patent foramen ovale noninvasively in patients with suspected paradoxical embolism or with questionable evidence of atrial septal defect. A positive study result does not specifically indicate heart disease since it occurs in healthy persons with patent foramen ovale, normal intracardiac pressures and no other abnormality.

Adolescent↗

PubMed1993

Relation between patent foramen ovale and unexplained stroke.

To better elucidate the possible role of the patent foramen ovale (PFO) in patients with unexplained stroke, the relation between the incidence of stroke and 3 characteristics of PFO (timing, magnitude of appearance of echocardiographic contrast in the left atrium, and morphology of the atrial septum) was analyzed. Twenty-nine patients with unexplained stroke and 28 without stroke were compared. A significant relation was only found between the incidence of cerebrovascular accident and positive contrast echocardiography in patients with early and massive passage of contrast in the left atrium (6 of 29 [21%] in the stroke group vs 0 of 28 [0%] in the control group; p < 0.05). An abnormal morphology of the foramen ovale was found more frequently in patients with PFO than in those without PFO (9 of 13 [69%] vs 1 of 44 [2%]; p < 0.001). The results suggest the use of timing and quantification of contrast appearance in the left atrium during contrast transesophageal echocardiography, and that paradoxical embolism through a PFO is a possible mechanism of cryptogenic stroke only if there is a massive passage of contrast through an abnormal foramen ovale.

Adult↗

PubMed1990

Human fetal foramen ovale flow velocity waveforms relative to behavioral states in normal term pregnancy.

In 16 normal pregnancies the relationship between foramen ovale flow velocity waveforms and fetal behavioral states at 37 to 38 weeks' gestation was studies with Doppler techniques. Foramen ovale flow velocity waveforms are characterized by a typical systolic/diastolic component. Average flow velocity was statistically significantly increased in behavioral state 2F (active sleep) as compared with state 1F (quiet sleep), which was mainly determined by an increase in flow velocity during the end-systolic and passive atrial filling phase. The increase in the average flow velocity at the foramen ovale level during active sleep suggests a redistribution of blood flow at the cardiac level, resulting in an increased right-to-left shunt.

Blood Flow Velocity↗

PubMed1996

Closure of a patent foramen ovale and tricuspid valve replacement after heart transplantation.

Patent foramen ovale has been noted after cardiac transplantation. Rarely is surgical intervention warranted. In this communication we report a case of severe tricuspid regurgitation and paradoxical embolism secondary to a patent foramen ovale in a patient 19 months after heart transplantation. The patient underwent successful closure of the patent foramen ovale and tricuspid valve replacement.

Bioprosthesis↗

PubMed1994

Location of the mandibular foramen in panoramic radiographs.

The reliability of two panoramic x-ray machines (Philips Orthoralix SD Ceph and Gendex Panelipse II) for determination of the location of the mandibular foramen was studied with the use of human dry mandibles. A significant correlation was found between the location of the mandibular foramen in the radiograph and the narrowest anteroposterior dimension of the ramus. A linear logistic regression equation was developed that could predict the actual location of the mandibular foramen from the radiographs. This finding will improve treatment planning of surgical splitting or fracturing of the ramus in cases that require orthognathic surgery provided the surgeon is aware of which panoramic machine was used. The Philips Orthoralix SD was found to be more reliable for this purpose than the Panelipse II (R2 = 0.94 and R2 = 0.87, respectively, in the vertical dimension and R2 = 0.87 and R2 = 0.75, respectively, in the horizontal dimension.

Humans↗

PubMed1995

The juxtacondylar approach to the jugular foramen (without petrous bone drilling).

BACKGROUND: Surgical access to the jugular foramen is generally realized through the infratemporal approach, requires petrous bone drilling with facial nerve exposure and sometimes transposition. This is a rather complex and time-consuming technique that exposes the patient to complications such as deafness and facial nerve palsy. METHODS: The juxtacondylar approach we propose in this paper needs only a partial mastoidectomy and exposure of the distal cervical segment of the vertebral artery (above C2). The transverse process of the atlas is completely removed so as to permit progress upward along the lateral mass of the atlas and the occipital condyle. The vertebral artery rarely has to be transposed. RESULTS: The main indication for the juxtacondylar approach is neurinoma and meningioma of the jugular foramen. For tumors like paraganglioma extending into the petrous bone, the juxtacondylar approach can be combined with an infratemporal approach. The juxtacondylar approach has been used in seven cases including three neurinomas, three paragangliomas and one meningioma. Exposure was quite satisfactory on both intra- and extradural parts in all cases. CONCLUSIONS: The juxtacondylar approach is a different way to expose the jugular foramen region. Compared to the standard infratemporal approach, it is a complementary rather than an alternative technique; the exposure is rather on the posteroinferior side for the juxtacondylar approach and on the anterosuperior side for the infratemporal approach.

Adult↗

PubMed2004

Recurrent transient ischemic attacks in a patient with intrapulmonary arteriovenous shunting detected after closure of a patent foramen ovale.

Paradoxical embolism through right-to-left shunts is widely accepted as a potential cause of cerebral ischemia. Contrast echocardiography is an excellent tool for detection of these shunts. The timing of the appearance of bubbles in the left atrium (ie, early vs late) allows differentiation of foramen ovale patency from intrapulmonary shunting as a result of arteriovenous malformations. We report a patient with recurrent neurologic deficit after surgical closure of a patent foramen ovale. Transesophageal echocardiography demonstrated residual right-to-left shunting from previously unrecognized pulmonary arteriovenous malformations associated with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu). This case illustrates the fact that contrast echocardiography may fail to identify intrapulmonary shunts when a resting patent foramen ovale coexists.

Adult↗