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PubMed1986

[Neuroradiological evaluation of benign extramedullary tumors in the high cervical region and at the foramen magnum].

Twelve cases of benign extramedullary tumors in the high cervical region and at the foramen magnum were experienced during past five years among eighty all spinal and paraspinal tumors. The diagnosis of masses in this region is very difficult because of the variety of clinical course, symptoms and neurological findings as pointed out by many reporters. Also in our cases, 70% of the patients complained of the deteriorated motor weakness of the upper or lower extremities on admission, though they had noticed the onset of slight neck or occipital pain a few years ago. Neurological examination on admission clearly showed the symptom of myelopathy except in two cases with a tumor at the foramen magnum and C1 level. The percentage of positive findings of plain X-rays was 50%, that of metrizamide myelography was 92% and that of IV. e. CT and met. e. CT was 100%. NMR-CT was performed in 2 cases, and in one of them it was useful in confirming the tumor configuration and extension. Five interesting cases were described mainly from the neuroradiological aspects. Finally the differentiation between meningioma and neurinoma was discussed from the aspects of myelogram, CT and NMR-CT. As already pointed out, it is most important not to forget the existence of tumors in this region when one comes across the confused symptoms, afterwards not to overlook the slight positive neurological and neuroradiological findings.

Accessory Nerve↗

PubMed1986

Emissary occipital foramen.

214 skulls were studied for the present study. A small foramen in the squamous part of the occipital bone just behind foramen magnum was noticed for the passage of emissary vein in one skull only, probably connecting occipital sinus with suboccipital venous plexus.

Cerebral Veins↗

PubMed1985

[Transoral anterior approach to foramen magnum meningioma--a case report and review].

A case of an anteriorly located meningioma in the region of the foramen magnum, successfully treated by a transoral approach, is reported. A 60-year-old woman was admitted to the author's department on January 19th, 1983. Six years before admission, she began to experience the gradual cold dysesthesia in the both palms, and then developed gait disturbance, clumsiness of the right hand and a stiffneck. She was found to have atrophied hands, mild spastic tetraparesis, ataxia and hypalgesia under the bilateral C2 spinal levels. A CT scan disclosed a patchy hyperdense lesion, which was enhanced homogenously with contrast medium, occupying almost all the intradural extramedullary space at the foramen magnum. The transoral approach was employed following preliminary tracheostomy. The tumor, extending about one centimeter superiorly to the basion and inferiorly to the upper border of C2 body, was removed completely, and then the dural defect was covered with a piece of fascia and gelform. An anterior occipitocervical fusion was performed extending to C2 using a block of an antogenous iliac bone. Post-operatively immobilization was secured by a Halo-Vest. But unexpectedly, CSF leakage was disclosed several days after the surgery without neurological deterioration. On the 17th day following first surgery, a re-operation was performed. The dural defect was successfully repaired with a piece of fascia by interrupted sutures in an illustrated fashion (Fig. 5). A piece of muscle was then placed in the epidural space created by bone removal. A fusion of the atlanto-axial joint not extending to the basiocciput was employed.(ABSTRACT TRUNCATED AT 250 WORDS)

Dura Mater↗

PubMed1985

Humerus length and foramen magnum area as indicators of size in birds.

In a group of birds (passerines and non-passerines) body weight was found to be highly correlated with the length of the humerus and with the area of the foramen magnum. In addition, body weight was highly correlated with humerus length in 58 specimens of streak-necked fly-catcher, Mionectes striaticollis, suggesting a possible use of this measurement to estimate body weight of individuals in a single species. Body weight was not correlated with foramen magnum area in 25 specimens of savannah sparrow, Ammodramus sandwichensis.

Animals↗

PubMed1994

Foramen magnum stenosis and bilateral benign subdural collections in achondroplasia: case report.

A case of achondroplasia is presented in which cervico-medullary junction compression by foramen magnum stenosis and generalized seizures by bilateral subdural effusions were relieved by suboccipital craniectomy with C1 laminectomy and drainage of the collections. The important role played by NMR in the diagnosis of foramen magnum stenosis is stressed; the possible causes of hydrocephalus and subdural collections in achondroplasic patients are discussed. According to the authors surgical drainage of benign subdural collections in these patients is indicated in case of intractable seizures.

Achondroplasia↗

PubMed1994

[Postlaminectomy kyphosis of the cervical spine complicating spinal cord tumor in the foramen magnum].

Postlaminectomy kyphosis is rarely encountered as a sequela of decompression of the upper cervical spine, especially in adults. We present a case of disabling cervical kyphosis which developed after laminectomy for excision of a foramen magnum tumor and was treated successfully by occipito-vertebral fusion. A sixty-one-year old female was treated by laminectomy of the first through to the third cervical spine for a foramen magnum meningioma. One year later, the laminectomy was extended downward to include the fourth through to the seventh cervical spine because of neurological deterioration. Seven years after the first laminectomy, she was referred to our spinal service because of severe neck pain, numbness and muscle weakness of both upper extremities. Lateral X-ray of her cervical spine presented a severe kyphosis. Roentgenogram two months after the first laminectomy already showed slight deformity and, timewise, it corresponded with the time when the patient experienced neurological deterioration. Subsequent X-rays showed progression of kyphosis. After we confirmed a lessening of the pain and improvement of the neurological symptoms during an axial traction using a halo-vest, posterior occipito-cervico-thoracic fusion was performed using Luque segmental spinal instrumentation and autogenous bone graft. After surgery the pain decreased and neurological symptoms improved. It is important to be aware of the complication of kyphotic deformity after laminectomy and once it has developed, it is recommended to stabilize the progression by early spinal fusion.

Cervical Vertebrae↗

PubMed1993

Giant posterior inferior cerebellar artery aneurysm associated with foramen magnum syndrome.

The case of a giant distal posterior inferior cerebellar artery (PICA) aneurysm which caused foramen magnum syndrome is presented. A 67-year-old male was referred for evaluation of a posterior fossa mass lesion on MRI scan. Craniotomy was performed which revealed a giant and completely thrombosed aneurysm of the distal PICA, which was subsequently excised intact. This report adds giant aneurysm of the PICA to the list of posterior fossa lesions reported which cause foramen magnum syndrome.

Aged↗

PubMed1996

[Foramen magnum meningioma of ventral type].

We reviewed the clinical findings and the surgical results of five cases of patients with foramen magnum meningioma of ventral type who underwent preoperative magnetic resonance imaging (MRI) and tumor removal by the posterolateral approach. Patients showed a variety of neurological symptoms and signs including dysesthesia of extremities, but the neurological diagnosis could not determine the dominant side of the tumor. MRI determined the dominant side of the tumor and this side was chosen as the side of the surgical approach. By MRI findings of the extent of the tumor in the posterior fossa and the spinal canal, patients were classified into three cases of craniospinal type and two cases of spinocranial type. The result of tumor removal by the posterolateral approach was a total removal in the two cases of spinocranial type and a "near-total" removal in the three cases of craniospinal type. There was no surgical mortality and the surgical morbidity was negligible. The foramen magnum meningioma of ventral type, especially of the spinocranial type, can be managed safely and satisfactorily by the posterolateral approach.

Adult↗

PubMed2004

Patent foramen ovale in cryptogenic stroke: current understanding and management options.

There is increasing interest in the association between patent foramen ovale (PFO) and documented stroke of unknown cause, commonly referred to as cryptogenic stroke. We reviewed the literature and, on the basis of the available data, designed a diagnostic and treatment algorithm for patients with PFO and cryptogenic stroke. Patent foramen ovale is relatively common in the general population, but its prevalence is higher in patients with cryptogenic stroke. Importantly, paradoxical embolism through a PFO should be strongly considered in young patients with cryptogenic stroke. There is no consensus on the optimal management strategy, but treatment options include antiplatelet agents, warfarin sodium, percutaneous device closure, and surgical closure. High-risk features in the patient's history (ie, temporal association between Valsalva-inducing maneuvers and stroke, coexisting hypercoagulable state, recurrent strokes, and PFO with large opening, large right-to-left shunt, or right-to-left shunting at rest, and a coexisting atrial septal aneurysm) should prompt PFO closure.

Adult↗

PubMed1983

Papilledema in the metastatic jugular foramen syndrome.

In a patient with Ewing's tumor, bilateral papilledema developed along with a left jugular foramen syndrome. Plain tomograms demonstrated a metastasis at the base of the skull. A digital intravenous angiogram showed an occlusion of the left transverse sinus at the level of the jugular foramen. The papilledema was explained by an increase in the intracranial pressure due to the rapid obstruction of venous drainage by the metastasis.

Adult↗

PubMed2002

Recurrent inner ear decompression sickness associated with a patent foramen ovale.

Isolated inner ear injuries occurring during shallow scuba dives are an uncommon manifestation of decompression sickness in recreational divers. We describe a patient who presented with the typical symptoms of inner ear involvement after 2 independent dives within the decompression limits. The diver reported symptoms of unilateral (right-sided) hearing loss, tinnitus, and vertigo after dives to 35 and 50 m. After treatment with hyperbaric oxygen, his symptoms completely resolved. To confirm the hypothesis of inner ear decompression sickness (IEDCS), we examined the patient for a right-to-left shunt by cranial Doppler ultrasound and found a patent foramen ovale. The existence of a patent foramen ovale is suspected to be a risk factor for developing neurological symptoms of decompression sickness. There was no evidence of any other risk factors, so we suggest that the relevant right-to-left shunt in our patient may have been the predisposing factor that caused the inner ear symptoms during his scuba dive.

Adult↗

PubMed1979

Reversible compression neuropathy of the eighth cranial nerve from a large jugular foramen schwannoma.

Jugular foramen schwannomas are unusual tumors occasionally resulting in neural hearing losses. Two previously reported cases document preservation of hearing following removal of a jugular foramen schwannoma. I report the third such case, in which there was progressive auditory and vestibular dysfunction seen on serial preoperative auditory tests and recovery of function seen on postoperative auditory and vestibular tests. The presumed pathophysiologic feature sub-serving this observation is compression neuropathy. I discuss experiences with compression neuropathy in animals and man under other circumstances.

Adult↗

PubMed1977

Richter hernia in a sacral foramen: new site for richter hernia.

This is a report of the first case to my knowledge, of a Richter hernia occurring in a sacral foramen. A 60-year-old woman had gradual onset of postsacral pain and swelling. The area was drained and small intestinal contents found. Laparotomy showed that a Richter hernia had occurred in the third right sacral foramen. The bowel had incarcerated and perforated into the posterior sacral area, without leakage into the peritoneal cavity.

Colon↗

PubMed2006

Patent foramen ovale and high-altitude pulmonary edema.

CONTEXT: Individuals susceptible to high-altitude pulmonary edema (HAPE) are characterized by exaggerated pulmonary hypertension and arterial hypoxemia at high altitude, but the underlying mechanism is incompletely understood. Anecdotal evidence suggests that shunting across a patent foramen ovale (PFO) may exacerbate hypoxemia in HAPE. OBJECTIVE: We hypothesized that PFO is more frequent in HAPE-susceptible individuals and may contribute to more severe arterial hypoxemia at high altitude. DESIGN, SETTING, AND PARTICIPANTS: Case-control study of 16 HAPE-susceptible participants and 19 mountaineers resistant to this condition (repeated climbing to peaks above 4000 m and no symptoms of HAPE). MAIN OUTCOME MEASURES: Presence of PFO determined by transesophageal echocardiography, estimated pulmonary artery pressure by Doppler echocardiography, and arterial oxygen saturation measured by pulse oximetry in HAPE-susceptible and HAPE-resistant participants at low (550 m) and high altitude (4559 m). RESULTS: The frequency of PFO was more than 4 times higher in HAPE-susceptible than in HAPE-resistant participants, both at low altitude (56% vs 11%, P = .004; odds ratio [OR], 10.9 [95% confidence interval {CI}, 1.9-64.0]) and high altitude (69% vs 16%, P = .001; OR, 11.7 [95% CI, 2.3-59.5]). At high altitude, mean (SD) arterial oxygen saturation prior to the onset of pulmonary edema was significantly lower in HAPE-susceptible participants than in the control group (73% [10%] vs 83% [7%], P = .001). Moreover, in the HAPE-susceptible group, participants with a large PFO had more severe arterial hypoxemia (65% [6%] vs 77% [8%], P = .02) than those with smaller or no PFO. CONCLUSIONS: Patent foramen ovale was roughly 4 times more frequent in HAPE-susceptible mountaineers than in participants resistant to this condition. At high altitude, HAPE-susceptible participants with a large PFO had more severe hypoxemia. We speculate that at high altitude, a large PFO may contribute to exaggerated arterial hypoxemia and facilitate HAPE.

Adult↗

PubMed1978

Evolutionary significance of the mandibular foramen area in Neandertals.

An unusual morphology of the mandibular foramen area is described, and its incidence determined for several fossil and modern hominid skeletal samples. This morphology, designated the horizontal-oval type mandibular foramen, is found in 46.2% of the 26 Neandertal foramina examined and in 23.1% of a European Upper Paleolithic sample of 13 foramina. In a total of 747 foramina from five modern skeletal samples, the highest incidence is 3.72%. Possible explanations for the presence of the H-0 trait and its unusually high incidence in Neandertals are examined. It is concluded that this feature is probably a genetic trait which either (1) might be selected for in Neandertals as a part of a massive masticatory apparatus, or (2) represents a discrete cranial trait without functional significance that simply reflects the high incidence of certain genes in Neandertal gene pools.

Biological Evolution↗

PubMed1987

Jugular foramen and mylohyoid bridging in an Asian Indian population.

The incidence of jugular foramen and mylohyoid groove bridging was studied in a population of East Asian Indian skulls (125 males and 109 females). The criteria of Dodo (J. Anat. 144:153-165, 1986) was used in the identification of a jugular bridge. There was an overall incidence of 8.1% in jugular foramen bridging, with males showing a higher rate, though the difference did not reach statistical significance. The right side showed a statistically significant greater occurrence than the left, and the trait tended to be associated between sides. The overall incidence of mylohyoid bridging was found to be 2.6%, with no difference observed between the sexes. This frequency is less than the values reported for other Asian Indian studies. Studies concerned with the incidences of nonmetric traits such as bony bridging may be useful in population studies especially when utilized in combination, thereby enhancing the value of each trait as an anthropological tool.

Female↗

PubMed1988

Tooth wear and the position of the mental foramen.

Variation in the position of the mental foramen with respect to the teeth ("apparent" position) seems to be associated with race, but in the determination of this position, factors which affect the disposition of the teeth plainly have a bearing on the results. The apparent position was investigated in a sample of southern Chinese skulls of known age which were classified by the degree of tooth wear. Controlling for "true" position and size of the mandible, a highly significant correlation between wear and position was found, age and tooth size having no significant contribution as additional explanatory variables. The effect of tooth wear on the apparent position of the foramen may partly explain racial variation.

Adolescent↗

PubMed1989

Mammalian frontal diploic vein and the human foramen caecum.

The course of the frontal diploic vein in the mole Talpa and the tree shrew Tupaia is described and compared to the frontal diploic vein of other mammals. The frontal diploic vein in Talpa and Tupaia connects the dorsal sagittal sinus to the veins of the orbit and has an emissary function. In certain other mammals it has a diploic function and may drain towards the orbit (e.g., Orycteropus) or towards the dorsal sagittal sinus (e.g., Didelphis). The frontal diploic vein of these mammals is not homologous to the vein of the human foramen caecum, but to the human frontal diploic vein. The vein of the foramen caecum is a problematic structure: its incidence in embryos and children is not clear.

Animals↗