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PubMedDate not supplied

Anatomic characteristics of foramen vesalius.

OBJECTIVES: Foramen Vesalius is an inconstant foramen that gives passage to an emissary vein that connects pterygoid venous plexus with cavernous sinus, the importance of which lies in the fact that an infected thrombus from an extracranial source may reach cavernous sinus. This study presents some data on characteristics of foramen vesalius. METHODS: We studied 70 sides of 35 dried adult human skulls available in the Department of Anatomy, Manipal College of Medical Sciences, Pokhara, Nepal. Variation in number and incidence of foramen Vesalius were noted. Differences between the right and the left side and between the male and the female sex are discussed. MAIN FINDINGS: Foramen Vesalius was present in 23 sides (14 right, 9 left) out of the 70 sides observed, the incidence being 32.85% (20.0% right side, 12.85% left side) of all the sides observed. Incidence of bilateral and unilateral foramen vesalius was 22.85% (8 out of 35 skulls) and 20% (7 out of 35 skulls) respectively. Foramen vesalius was found in 10 sides in males and in 13 sides in females. No remarkable differences were observed in the incidence of foramen vesalius between the sides within same sex but the incidence was more in females compared to male skulls. SIGNIFICANCE OF FINDINGS: Anatomic variations of the foramen vesalius could be explained by developmental reasons. Knowledge about characteristics of foramen vesalius and its incidence is not only important for anatomists but equally essential for an operating surgeon.

Cadaver↗

PubMed1986

Observations on the bony bridging of the jugular foramen in man.

The anatomical nature and pattern of incidence of bony bridging of the jugular foramen was investigated using 64 fetal crania aged nine months to term and 222 adult crania of Japanese. In addition, the region of the jugular foramen of an adult cadaver was carefully dissected in order to clarify the relationship between the cranial nerves passing through the jugular foramen and the intrajugular processes of the jugular foramen. The general conclusions concerning the anatomical nature of the bony bridging of the jugular foramen were as follows. (1) The intrajugular process of the temporal bone is situated posterior to the triangular depression (as described in Gray's Anatomy) of the petrous part. (2) The bony bridging of the jugular foramen is established by the contact of the intrajugular process of the temporal bone with the bony process of the occipital bone projecting either from just above the hypoglossal canal (Type I) or from posterior to the hypoglossal canal (Type III). (3) If both the processes of the occipital bone reach the intrajugular process of the temporal bone simultaneously, the jugular foramen is divided into three compartments. (4) In the case of Type I bridging, the anteromedial compartment transmits the glossopharyngeal nerve, while the posterolateral compartment gives passage to the vagus nerve, the accessory nerve and the internal jugular vein. (5) In the case of Type II bridging, the anteromedial compartment contains the glossopharyngeal, vagus and accessory nerves, and the posterolateral compartment transmits the internal jugular vein. (6) When tripartite division of the jugular foramen occurs, the anteromedial compartment transmits the glossopharyngeal nerve, the middle compartment contains the vagus and accessory nerves, and the posterolateral compartment transmits the internal jugular vein. Concerning the pattern of incidence of jugular foramen bridging in the Japanese fetal and adult cranial series, this is similar to that of the bony bridging of the hypoglossal canal. The fact that almost all the cases of bridging of the jugular foramen are already established by the end of fetal development must serve as a strong indication that this trait can be used effectively for anthropological population studies.

Adult↗

PubMed2001

[Microsurgical treatment of foramen magnum tumors].

OBJECTIVES: To review the radiological features, and results of microsurgical treatment of foramen magnum tumors. METHODS: We retrospectively analyzed the results of microsurgical treatment of 31 patients with foramen magnum tumor. Fifteen patients had pathological schwannomas (neurinomas), 13 patients meningiomas, and 3 patients chordomas. According to tumor extension, MRI findings and microsurgical approaches, the tumors were classified in two types. Type I tumors located at the ventral foramen magnum, including those originated from the posterior fossa with minimal enlargement of the ventral or anterior-lateral (15 patients). Type II tumors located at the posterior or lateral foramen magnum, including those arising from the spinal canal with minimal enlargement of the foramen magnum (16 patients). Surgical approaches to tumors in this series included suboccipital posterior approach (18 patients), extreme lateral or transcondylar approach (10), and suboccipital retrosigmoid approach (3). RESULTS: Total removal was achieved in 25 patients, subtotal removal in 5, and partial removal in 1. No operative death occurred. Type I foramen magnum tumors were totally removed in 9 patients, subtotally removed in 5 and partially removed in 1. All of type II foramen magnum tumors were totally removed. CONCLUSIONS: To totally resect type I foramen magnum tumors, extreme lateral transcondylar approach is an optimal choice. Type II foramen magnum tumors can be totally removed with good prognosis.

Adolescent↗

PubMed2005

The cranio-orbital foramen, the groove on the lateral wall of the human orbit, and the orbital branch of the middle meningeal artery.

The cranio-orbital foramen, a foramen in the lateral wall of the orbit, contains an anastomosis between the anterior branch of the middle meningeal artery and the lacrimal artery. Previous workers have speculated that the groove starting either from the cranio-orbital foramen or the lateral extremity of the superior orbital fissure contains the anastomotic artery. We investigated the cranio-orbital foramen and the groove on the lateral wall of the orbit in a series of 170 dried adult human skulls, and the course of the orbital branch of the middle meningeal artery in 74 specimens from 37 cadavers. We observed the cranio-orbital foramen in 141 skulls (82.9%). It was unilateral in 55 (32.4%) and bilateral in 86 (50.6%) skulls. The groove on the lateral wall of the human orbit was observed in 122 skulls (71.8%). It was unilateral in 40 (23.5%) and bilateral in 82 (48.2%). The groove on the lateral wall of the orbit started from the cranio-orbital foramen in 20 skulls (11.8%). The orbital branch of the middle meningeal artery was found in 48 cadaveric specimens (64.9%): 32 (43.2%) passed through the cranio-orbital foramen and 12 (16.2%) passed through the superior orbital fissure. In four specimens (5.4%), orbital branches of the middle meningeal artery passed through both the superior orbital fissure and the cranio-orbital foramen. The anatomy of the cranio-orbital foramen and the course of the orbital branch should be well known by surgeons reconstructing the anterior base of the skull, the orbit after orbital base surgery, and during excision of meningiomas.

Cadaver↗

PubMed2004

Clinical perspectives on secular trends of intervertebral foramen diameters in an industrialized European society.

Low back pain origins have been a matter of great controversy. While spinal stenosis is now radiologically traceable, the alteration of intervertebral foramen is less clear. The aim of this study was to assess "secular trends"-alterations occurring from one generation to the next-in osseous intervertebral foramina of the major vertebral segments in an industrialized society, and to discuss their possible clinical implication. The macerated "maximum intervertebral foramen width" and "intervertebral foramen height" of all major vertebral levels in 71 non-pathologic Swiss adult skeletons from the nineteenth and early twentieth century, with known individual age and sex and similar geographic and socio-economic background, were measured by sliding caliper at validated landmarks. A secular trend of the increase in "maximum intervertebral foramen width" is found for most levels, with females showing a more prominent alteration. Additionally, the non-pathologic "maximum intervertebral foramen width" does not change with respect to individual age, nor is a significant side difference detectable. "Intervertebral foramen height," hereby defined as the difference of the dorsal vertebral body height minus pedicle height, demonstrates for most levels, and either sex, an insignificant negative secular trend. Neither stature nor skeletal robustness vary significantly through time within this particular sample. The results of this study, despite obvious inadequacies of methods used, exclude secular narrowing of the "maximum intervertebral foramen width" as the only cause of radiculopathy or spinal stenosis. Furthermore, we found a mild insignificant decrease of the clinically more relevant "intervertebral foramen height." Nevertheless, the detected short-time variability of the bony intervertebral foramen, independent of individual stature, skeletal robustness or age, argues for an enhanced focus on the understanding of clinically relevant changes of spinal morphology from generation to generation.

Adult↗

PubMed1993

The cough test is superior to the Valsalva maneuver in the delineation of right-to-left shunting through a patent foramen ovale during contrast transesophageal echocardiography.

A patent foramen ovale may result in paradoxical embolization and serious morbidity. Thus a sensitive method to diagnose a patent foramen ovale is important. It is unknown whether the cough test or the Valsalva maneuver is superior in delineating right-to-left shunting through a patent foramen ovale during contrast transesophageal echocardiography. Thus we studied 73 consecutive patients (53 men and 20 women), aged 54 +/- 16 years (range 18 to 79 years), during elective transesophageal echocardiography. Contrast transesophageal echocardiography was performed from a four-chamber view during quiet respirations, Valsalva maneuver, and cough test. In the entire group the incidence of a patent foramen ovale was higher during the cough test (32/73) as compared with the Valsalva maneuver (24/73, p < 0.025) and quiet respirations (18/73, p < 0.005). All subjects with a patent foramen ovale during the Valsalva maneuver had a positive contrast transesophageal echocardiogram during the cough test. In subjects (n = 55) without a patent foramen ovale during quiet respirations, the incidence of a patent foramen ovale was higher during the cough test (15/55) as compared with the Valsalva maneuver (9/55, p < 0.05). In a subgroup (N = 17) of patients with nonhemorrhagic stroke (n = 11), transient ischemic attack (n = 2), or peripheral embolus (n = 4), the cough test had a higher yield (9/17) in delineating a patent foramen ovale as compared with the Valsalva maneuver (7/17) but did not reach statistical significance. These data demonstrate that the cough test is superior to the Valsalva maneuver in delineating a patent foramen ovale during contrast transesophageal echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1992

Patent foramen ovale in patients with haemodynamically significant pulmonary embolism.

The prevalence of a patent foramen ovale is about 1 in 4. In cases with venous thromboembolism and raised right heart pressures, a patent foramen ovale may permit paradoxical emboli, which could complicate the course of patients with pulmonary embolism. Echocardiography enables detection of a patent foramen ovale in life. We have studied 85 patients who presented with haemodynamically significant pulmonary embolism as judged by clinical, echocardiographic, or haemodynamic indices and who had an echocardiographic evaluation for patent foramen ovale. 33 patients (39%) had a patent foramen ovale. Clinical symptoms suggestive of paradoxical embolism were more likely in patients with than in those without a patent foramen ovale (39% vs 6%, p = 0.00034), with new neurological deficits occurring in 11 patients (9 vs 2, p = 0.005) and a vascular occlusion in 8 (7 vs 1, p = 0.0096). Arterial oxygen tension was lower in patients with a patent foramen ovale (mean 55 [SD 14] vs 62 [16] mm Hg, p = 0.038). Mortality was not different between the two groups (27% vs 19%). Cardiopulmonary complications in terms of resuscitation, intubation, or the use of catecholamines were more frequently observed in patients with a patent foramen ovale (48% vs 23%, p = 0.028). Patients with a patent foramen ovale and haemodynamically significant pulmonary embolism are more likely to have arterial hypoxaemia and vascular occlusions, possibly due to paradoxical emboli.

Adult↗

PubMed2004

Ontogenetic migration of the mental foramen in Neandertals and modern humans.

Since the nineteenth century, researchers have noted that Neandertal and modern human adults differ in mental foramen position, although the ontogenetic changes in the position of this feature have only recently come under the scrutiny of paleoanthropologists. Research on mental foramen position has focused on whether this feature is inferior to a particular tooth. However, tooth position may not be a reliable indicator of mental foramen position because of variability in tooth size within and between taxa and during eruption events. As opposed to observing the mental foramen with respect to the postcanine teeth, we examined linear distances from the mental foramen to other mandibular landmarks. Modern human adults may appear truncated, or paedomorphic, in mental foramen position with respect to Neandertal adults. However, infants of the two taxa differ substantially in anterior mandibular form. The initial differences in the shape of the mental region may be related to the embryological position of the mental foramen in modern humans and its role in the development of the mental trigone. The shape changes that accrue thereafter, possibly from faster mandibular growth rates in Neandertals, further distinguish the adults from one another. Although mandibular shape differences exist from early infancy onwards, adults of the two taxa are broadly similar in bi-mental foramen breadth with respect to mandibular size. For this reason, qualitative assessments of mental foramen position may provide less taxonomic information than previously thought.

Adult↗

PubMed2006

Clinical and anatomical study of retromolar foramen and canal.

PURPOSE: The retromolar canal is a rare anatomic variation of the mandible. The neurovascular content of the mandibular retromolar canal is very important for surgical procedures involving the retromolar area and there has been a lack of information on this subject. This study consists of anatomic research of the retromolar foramen and canal, planned after an impacted third molar tooth extraction operation in which we encountered a retromolar neurovascular bundle. MATERIALS AND METHODS: Eighty sides of 40 mandibles were evaluated and the presence of the retromolar foramen and its relation to the last teeth, the transverse and sagittal distances of the retromolar trigone, and the distance of the retromolar foramen to the last socket of the arch were measured. RESULTS: The neurovascular bundle includes striated muscle fibers, thin myelinated nerve fibers, numerous venules and a muscular artery. Of the 40 mandibles included in this study, retromolar foramens were found in 10 (25%). The presence of the retromolar foramen is not dependent on the last teeth of the arch. The dimensions of the retromolar trigone were measured and the presence of the retromolar foramen was found to be nonrelevant to the dimensions of the retromolar trigone. Retromolar foramen distance from the distal edge of the last socket of the arch was found to be 11.91 +/- 6.71 mm and 4.23 +/- 2.30 mm, respectively, from the second and third molars. CONCLUSIONS: This study therefore clearly establishes the incidence and importance of the retromolar canal. This study shows that the retromolar foramen and canal can be seen occasionally in routine dental surgery. Due to the neurovascular bundle passing through it, the retromolar canal and foramen must be kept in mind in all anesthetic and surgical approaches regarding the retromolar area and mandible.

Adult↗

PubMed2003

[Prevalence of patent foramen ovale in young patients with cerebral ischemic accident of unknown origin].

INTRODUCTION AND OBJECTIVE: Patent foramen ovale has been associated with stroke in young patients with cryptogenic stroke. The purpose of this study is to examine the prevalence of patent foramen ovale in this group of patients, as well as their anatomical and functional characteristics by contrast echocardiography, trying to determine ictus risk markers in young patients with acute ischemic stroke. PATIENTS AND METHOD: Prospective study of 90 patients under the age of 50 who were hospitalised consecutively due to a clinical presentation suggestive of stroke. No cause was found in 55 out of 90 (group I) and the rest, in which an stroke was finally disregarded, were used as the control group (group II). A transthoracic and transesophageal echocardiography examination with 2 types of contrast agents was performed in all patients to determine the presence of a patent foramen ovale and its anatomical and functional characteristics. RESULTS: Patent foramen ovale was observed more frequently in group I than in group II (43 versus 21%; p < 0.05). Among patients with a patent foramen ovale those with an ischemic stroke showed greater mobility of the oval membrane, more frequent large shunts of contrast in a single frame in the left heart, and more frequent shunts at rest. Transesophageal echocardiography without contrast showed a high sensitivity (90%) and specificity (93%) for detecting anatomically permeable foramen ovale whereas contrast transthoracic echocardiography showed a low sensitivity (13%). There were no differences between the two contrasts used. CONCLUSIONS: Near half of young patients with ischemic stroke of an unknown origin have a patent foramen ovale. A bigger mobility of the membrane of the oval cavity and a large degree of shunt contrast as well as shunt at rest detected by contrast transesophageal echocardiography, seem to identify patent foramen ovale patients with ischemic stroke. In these patients, transthoracic echocardiography has low sensibility for detecting permeability of the foramen ovale.

Adult↗

PubMed1996

The location of the vertebral artery foramen and its relation to posterior lateral mass screw fixation.

STUDY DESIGN: This study evaluated the anatomic relationship between the vertebral artery foramen and the posterior midpoint of the cervical lateral mass using cervical spine specimens. OBJECTIVES: To determine quantitatively the location of the vertebral artery foramens from C3 to C6 and their relationship to the posterior midpoints of the lateral masses. SUMMARY OF BACKGROUND DATA: Anatomic studies of the cervical nerve root and facet relative to lateral mass screw placement have been addressed. It is necessary to know the correct location of the vertebral artery foramen during lateral mass screw placement to minimize the risk of injury to the vertebral artery. METHODS: Forty-three cervical spines from C3 to C6 were directly evaluated for this study. Anatomic evaluation included the dimension of the vertebral artery foramen and its projection on the posterior aspect of the lateral mass. The vertical distance from the posterior midpoint of the lateral mass to the posterior border of the vertebral artery foramen, and the angle between the parasagittal plane and the line connecting the posterior midpoint of the lateral mass with the lateral limit of the vertebral artery foramen, were also measured. RESULTS: The vertical distances from the posterior midpoint of the lateral mass to the vertebral artery foramens at C3-C6 averaged from 9.3 to 12.2 mm for male and female specimens. The average angles medial to the sagittal plane, between the parasagittal plane and the line connecting the posterior midpoint of the lateral mass with the lateral limit of the vertebral artery foramen, from C3 to C5, were found to range from 6.0 degrees to 6.3 degrees for male specimens and from 5.3 degrees to 5.5 degrees for female specimens. At C6, the average angles lateral to the sagittal plane, between the parasagittal plane and the line connecting the posterior midpoint of the lateral mass with the lateral limit of the vertebral artery foramen, were 6.4 degrees for male specimens and 5.4 degrees for female specimens. CONCLUSIONS: The present study indicated that there is no risk of damaging the vertebral artery if a screw is directed perpendicular to the posterior aspect of the lateral mass at C3-C5 and 10 degrees lateral to the sagittal plane at C6 starting at the midpoint of the lateral mass.

Adult↗

PubMed1993

Patent foramen ovale: is stroke due to paradoxical embolism?

BACKGROUND AND PURPOSE: A patent foramen ovale has been reported to be significantly more frequent in young stroke patients than in matched control subjects, and paradoxical embolism has been suggested as the main mechanism of stroke in this situation. The present study was designed to test this hypothesis. METHODS: Sixty-eight consecutive patients under 55 years of age presenting with an ischemic stroke had an extensive workup, including transesophageal echocardiography with contrast. We compared the prevalence of criteria for the diagnosis of paradoxical embolism in patients with and without a patent foramen ovale. RESULTS: A patent foramen ovale was found in 32 patients (47%). A Valsalva-provoking activity was present at stroke onset in six patients with a patent foramen ovale and in eight patients with no patent foramen ovale (chi 2 = 0.1, nonsignificant). Clinical/radiological features suggestive of an embolic mechanism were not more frequent in patients with a patent foramen ovale. Clinical evidence of deep vein thrombosis was present in one patient with a patent foramen ovale and in none of the others. No occult venous thrombosis was found in a subgroup of patients with a patent foramen ovale and no definite cause for stroke who underwent venography (n = 13). CONCLUSIONS: Our results do not support the hypothesis that paradoxical embolism is the primary mechanism of stroke in patients with a patent foramen ovale.

Adult↗

PubMed2006

Scalp to meningeal arterial anastomosis in the parietal foramen.

OBJECTIVE: The purpose of this study was to examine the parietal foramen and to determine whether it is the site of an anastomosis between the meningeal and scalp arteries. METHODS: Forty parietal regions from 20 adult cadavers, in which the arteries were perfused with colored latex, were examined for this study. The scalp was separated from the parietal foramen, and the vasculature in the foramen and adjacent scalp and dura were examined using x3 magnification. The scalp arteries that anastomosed with the meningeal arteries through the parietal foramen were followed into the dura after craniotomy. RESULTS: Parietal foramen was found in 20 of the 40 (50%) parietal regions. They were present bilaterally in eight heads and unilaterally in four. Every parietal foramen transmitted an anastomosis between the middle meningeal and scalp arteries. In 11 (55%) of the 20 foramina found in this study, the superficial temporal and occipital artery formed an anastomosis in the galea and pericranial layer that sent a branch through the parietal foramen to anastomose with parietal branches of the middle meningeal artery. In the remaining nine (45%) sides, the middle meningeal artery had a connection through the foramen with a small pericranial artery. CONCLUSION: Every parietal foramen was the site of a connection between the middle meningeal and scalp arteries. The scalp end of the anastomosis most commonly arose in an anastomosis between the superficial temporal and occipital arteries. This anastomosis may be involved in several pathologies.

Arteriovenous Anastomosis↗

PubMed2000

A study of the position of the mandibular foramen in adult black Zimbabwean mandibles.

OBJECTIVES: To determine the position of the mandibular foramen on dry adult mandibles and hence provide valuable information for dental and other health practitioners for successful inferior alveolar nerve anaesthesia. DESIGN: A cross sectional study. SETTING: Department of Anatomy, Faculty of Medicine, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe. SUBJECTS: 38 dry mandibles from adult black Zimbabweans. MAIN OUTCOME MEASURES: The anterior and posterior rameal widths, upper and lower rameal heights and the height of the lingula were measured with respect to the position of the mandibular foramen. The distribution of the foramen in relation to the occlusal plane was determined. RESULTS: The results showed that the position of the mandibular foramen was highly individualistic but on average lies at about 2.56 mm (right) and 2.08 mm (left) behind the midpoint of rameal width and at approximately 3 mm superior to the midpoint of rameal height on both sides. The mean anterior and posterior rameal widths were respectively 18.95 +/- 0.41 and 14.30 +/- 0.35 while the mean rameal heights were respectively 22.50 +/- 0.50 (upper) and 28.44 +/- 0.65 (lower). The distribution of the foramen in relation to the occlusal plane was 47.1% at the same level with the occlusal plane, 29.4% above, and 23.5% below the plane. There was no side variation in the position of the foramen in relation to the occlusal plane, in the dimensions of the ramus and in the size of the mandibular foramen but individual variations exist. The height of the lingula however showed great variation. The mean height was 8.40 +/- 0.39 (right) and 8.36 +/- 0.38 (left). CONCLUSION: The study has shown similarities and differences between the rameal dimensions and the position of the mandibular foramen in adult black Zimbabwean mandibles and those of other subpopulations. The clinical significance of accurately locating the mandibular foramen during a local anesthetic block of the inferior alveolar nerve is discussed.

Adult↗

PubMedDate not supplied

The position and dimensions of the mental foramen in adult Malawian mandibles.

BACKGROUND: The mental foramen is found on the anterolateral aspect of the mandible and transmits the mental nerve and vessels. The identification and actual location of this foramen is very important in clinical dentistry as well as in the microscopic and macroscopic evaluation of the morphology and maturity of the human mandible. METHODOLOGY: We determined the position and dimensions of this foramen from seventy adult indigenous Malawian mandibles of both sexes. The shape, number and orientation of the mental foramen were determined by visual examination and its transverse and vertical diameters measured using a digital venier caliper. RESULTS: In the majority of cases, the mental foramen was oval in shape, oriented posterosuperiorly, and bilaterally symmetrical. The modal position of the foramen with respect to the mandibular teeth was inferior to the second premolar tooth. Its vertical position was slightly below the midpoint of the distance between the lower border of the mandible and the alveolar margin. CONCLUSION: The shape and orientation of the mental foramen shown in our study correspond to what have been documented in most previous studies. However, variations do exist in the modal position of this foramen in different population groups. We therefore stress the importance of palpation of the foramen during administration of local anaesthesia and in the interpretation of radiographs prior to surgery.

Adult↗

PubMed1992

Patent foramen ovale as a risk factor for cryptogenic stroke.

OBJECTIVE: To determine and compare the prevalence of patent foramen ovale in patients with stroke of undetermined origin (cryptogenic) and in patients with stroke of determined origin to assess the possible role of patent foramen ovale as a risk factor for cryptogenic stroke. DESIGN: Cross-sectional study with nested case-control analysis. PATIENTS: A total of 146 patients (73 men, 73 women) with acute ischemic stroke referred to the echocardiography laboratory for evaluation. SETTING: Neurovascular Unit and Echocardiography Laboratory, Columbia-Presbyterian Medical Center, New York, New York. MEASUREMENTS: Patients were considered to have strokes of determined origin or cryptogenic strokes according to National Institute of Neurological Disorders and Stroke (NINDS) Stroke Data Bank criteria. The presence of patent foramen ovale was assessed by contrast echocardiography, performed blinded for type of stroke. The association between patent foramen ovale and type of stroke was tested after correcting for patients' demographic variables and stroke risk factors. RESULTS: The overall prevalence of patent foramen ovale was 26 of 146 patients (18%; 95% Cl, 11.4% to 24.6%). Patients with cryptogenic stroke (31%) had a significantly higher prevalence of patent foramen ovale than did patients with an identifiable cause of stroke (69%) in both the younger (less than 55 years; 48% compared with 4%; P less than 0.001) and the older (greater than or equal to 55 years; 38% compared with 8%; P less than 0.001) age groups. Multiple logistic regression analysis was used to identify the presence of a patent foramen ovale as strongly associated with the diagnosis of cryptogenic stroke (odds ratio, 7.2; Cl, 2.4 to 21.7), irrespective of patient age and other stroke risk factors. CONCLUSIONS: Patients with cryptogenic stroke have a higher prevalence of patent foramen ovale than patients with stroke of determined cause in all age groups, even after correcting for the presence of recognized stroke risk factors. This identifies patent foramen ovale as a risk factor for cryptogenic stroke. Regardless of patient age, contrast echocardiography should be considered when the cause of stroke is unknown.

Adult↗

PubMed2004

[The study of microdissection of endoscopic transnasal surgery in the sphenopalatine foramen].

OBJECTIVE: To provide anatomy evidence for endoscopic transnasal surgery in the sphenopalatine foramen by measuring and dissecting corpses. METHOD: The position, shape, size and their correlational data of sphenopalatine foramen of 40 sides skulls in adults were measured. RESULT: Classification of the sphenopalatine foramen were as three types: I 35%; II 5%; III 60%. The mean distance from upper edge of the sphenopalatine foramen to the base of the sphenopalatine sinus was male (1.75 +/- 1.10) mm, female (1.13 +/- 0.55) mm, and to the apertura sphenopalatine sinus was male (9.80 +/- 3.27) mm, female (8.30 +/- 3.45) mm. The mean distance from the posterior edge of the sphenopalatine foramen to the rhinopharynx was male (11.12 +/- 3.30) mm, female (10.85 +/- 3.12) mm. The mean distance from the anterior edge of the sphenopalatine foramen to the apertura maxillaris was male (18.50 +/- 6.80) mm, female (14.57 +/- 5.07) mm, and to the apex of nose was male (69.54 +/- 6.98) mm, female (66.57 +/- 5.07) mm, and to the nasospinale was male (56.69 +/- 5.70) mm, female (53.25 +/- 8.80) mm. The horizontal diameter of the sphenopalatine foramen was female (4.61 +/- 1.80) mm, male (5.12 +/- 2.05) mm. The vertical diameter was male (5.37 +/- 2.67) mm, female (0.35 +/- 0.07) mm. The surface diameter of the sphenopalatine artery and nerves was male (2.12 +/- 0.66) mm, female (1.61 +/- 0.70) mm, and male (0.65 +/- 0.49) mm, female (0.35 +/- 0.07) mm. The mean angle from the sphenopalatine foramen to the horizontal plate of palatine bone was male (22.83 +/- 4.71) degrees, female (22.73 +/- 3.81) degrees. Nasal lateral walls were controlled by lateral posterior nasal arteries and nerves, which were classified into three types: I 70%, II 20%, III 10%. CONCLUSION: The observation and survey about the sphenopalatine foramen will supply clinic with anatomy homological.

Adult↗

PubMedDate not supplied

The significance of asymmetry of the foramen of Vesalius.

The foramen of Vesalius is a small, variable but consistently symmetrical structure located anteromedial to the foramen ovale and lateral to the foramen rotundum and vidian canal. It transmits an emissary vein through which the cavernous sinus and pterygoid plexus communicate. Fifty high-resolution CT scans of the skull base and two three-dimensional (Cemax) reconstructions were reviewed to determine criteria for defining the normal appearance of the foramen of Vesalius. Three normal types were classified: (1) a well-formed foramen, 1-2 mm in size (n = 32); (2) lack of visualization of the foramen (n = 11); and (3) partial assimilation of the foramen with the foramen ovale (n = 7). The foramen was remarkably symmetric in a large number of cases (n = 48). Asymmetry signified abnormality in four of the six cases. Abnormal causes of asymmetry included invasion by nasopharyngeal melanoma, angiofibroma, carotid cavernous fistula with drainage through the emissary vein, and neurofibromatosis. Thus, for these usually symmetric foramina of Vesalius, asymmetry is more likely the result of a pathologic process than a normal variant.

Arteriovenous Fistula↗