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At least 127 records · Page 7Linked to original sources

PubMed2001

Relation between directly detected patent foramen ovale and ischemic brain lesions in sport divers.

BACKGROUND: In divers, the significance of a patent foramen ovale and its potential relation to paradoxical gas emboli remain uncertain. OBJECTIVE: To assess the prevalence of symptoms of decompression illness and ischemic brain lesions in divers with regard to the presence of a patent foramen ovale. DESIGN: Retrospective cohort study. SETTING: University hospital and three diving clubs in Switzerland. PARTICIPANTS: 52 sport divers and 52 nondiving controls. MEASUREMENTS: Prevalence of self-reported decompression events, patent foramen ovale on contrast transesophageal echocardiography, and ischemic brain lesions on magnetic resonance imaging. RESULTS: The risk for decompression illness events was 4.5-fold greater in divers with patent foramen ovale than in divers without patent foramen ovale (risk ratio, 4.5 [95% CI, 1.2 to 18.0]; P = 0.03). Among divers, 1.23 +/- 2.0 and 0.64 +/- 1.22 ischemic brain lesions per person (mean +/- SD) were detected in those with and those without patent foramen ovale, respectively. Among controls, 0.22 +/- 0.44 and 0.12 +/- 0.63 lesion per person were detected (P < 0.001 for all groups). CONCLUSIONS: Regardless of whether a diver has a patent foramen ovale, diving is associated with ischemic brain lesions.

Adult↗

PubMed1992

The foramen meningo-orbitale and its relationship to the development of the ophthalmic artery.

The incidence of the foramen meningo-orbitale is reported from a sample of 50 adult dried skulls. The foramen meningo-orbitale is not an inconsistent finding, being identifiable in half of the samples studied. Multiple foramina may exist. Although the location of the foramen meningo-orbitale is not fixed, it lies along or near the suture leading superolaterally from the superior orbital fissure. The foramen represents the remnant of an embryonic conduit for the supraorbital division of the stapedial artery en route to the orbit and the developing ophthalmic artery. An alternative, more medial, pathway exists through the superior orbital fissure. The embryonic anastomosis that occurs between the internal and external carotid systems does not occur at the level of this foramen, but closer to the optic nerve as a portion of the primitive 'ring' artery. The term 'stapedial-ophthalmo-lacrimal' foramen is proposed to proclaim the embryonic significance of this foramen.

Humans↗

PubMed1990

[Age changes in location of mandibular foramen].

In order to understand the changes in location of the mandibular foramen with age in children, lateral cephalometric radiographs from 112 child and adult patients, including both males and females, were randomly selected according to age. The subjects were divided into 6 age-groups; 3, 5, 7, 9, 11 and adult. Certain lines and points were traced on the radiographs used. The location of the mandibular foramen was identified by two persons. The perpendicular distance from the center of the mandibular foramen to the occlusal plane and the location of the mandibular foramen relative to the ramus height (Ar-Kk), as well as to the ramus width (a-p), were measured. The mandibular foramen was located 4.12 mm below the occlusal plane at the age of 3. It subsequently moved upward with age. By the age of 9, it had reached approximately the same level as the occlusal plane. The foramen continued to move upward to 4.16 mm above the occlusal plane in the adult group. The height percentage averages ranged from the lower 1/3 of the ramus height in the 3 year-old group to the middle of the ramus height in adults. The depth percentage averages ranged from 67.8% in 3 year-old children to 61.7% in adults. For greater accuracy in anesthetic procedures, dentists should relate the locational changes in the mandibular foramen with age when performing block anesthesia for the inferior alveolar nerve.

Adult↗

PubMed1990

[The Sistrunk median cervical cyst operation using a cecal foramen pointer].

The cecal foramen pointer was invented for a Sistrunk median cervical cyst operation. The instrument consists of three elements, namely: The cecal foramen holder, the giraffe shaped connector and the pointer needle. First of all, the cecal foramen is held by the holder which is reconstructed from hemostatic forceps. The one end of the connector is joined to the holder's handle. Then the other end of the connector comes along the patient's chin, in front of the neck. The cyst and mid-portion of the hyoid bone are dissected, followed by coring out of the thyroglossal duct toward the cecal foramen. In the coring out process, the pointer needle is pierced through the tunnel of the connector's opposite end, so that the needle top reaches to the bottom of operative wound. Then the needle shows exactly the direction to the cecal foramen and the distance from the bottom of the wound to the cecal foramen. By using this instrument the operation was successfully performed for a case of a recurrent median cervical cyst with a complete fistula to the cecal foramen.

Humans↗

PubMed1989

The mandibular incisive foramen.

An anatomical variant in the region of the mental foramen is discussed. In these cases the inferior alveolar nerve divides into its two terminal branches only after it has exited through the mental foramen. The incisive nerve thus commences outside the mandible, and has a short extra-osseous course before it enters the mandible through a separate foramen on the same horizontal plane. For the distance between these two foramina there is no nerve supply within the mandible. The groove between the two foramina may be the remnants of the mandibular canal. The foramen through which the nerve enters the bone is a separate anatomical entity from the mental foramen and should be recognised as such. It is proposed that this foramen be named the mandibular incisive foramen.

Humans↗

PubMed1989

Antero-posterior location of the mental foramen in Nigerians.

The location of the mental foramen in the horizontal plane was studied in 604 oblique lateral radiographs of the mandible. The foramen was related to the apex of the second premolar root in 55.63 percent of the radiographs, while 26.99 percent occurred in the interdental space between the first and second premolars. Location between the roots of the second premolar and first molar was observed in 12.25 percent while relationship to the roots of the first molar was found in 3.30 percent. Location around the apex of the first premolar accounted for 1.66 percent. Only one foramen (0.17 percent) was found mesial to the first premolar. The radiographs of the right and left sides were available for 277 patients. The location of the mental foramen was asymmetrical in 12.3 percent of these patients, the right foramen being more frequently located posteriorly than the left foramen. The prevalence of asymmetrical location of the foramen was more frequent in females in whom it occurred in 53 percent.

Anesthesia↗

PubMedDate not supplied

[Study in SEM of the number and size of the main and accessory foramens of the first lower premolars].

The authors in this study have been used the apexes, 4 mm in length, from 93 first lower premolars, from patients over 45 years old. All specimens were prepared for SEM visualization. It was found that in 84.95% of them there was present at least one accessory foramen. All accessory foramens has a diameter less than 100 microns, with a mean value 52 microns. Also in a 74.19% of the 93 teeth, there was present a second main foramen. These foramens had a diameter more than 100 microns, with a mean value 368 microns. Finally it was found that when an extra main foramen was present, the mean value of the diameter remained the same and not smaller than that of the teeth with one main foramen. This may be of a significant clinical value, because this means that the pulp takes extra volumes of blood from these extra foramens.

Bicuspid↗

PubMed2001

Dural arteriovenous fistulae at the foramen magnum.

Spinal dural arteriovenous fistulae (DAVF) affect predominantly levels of the lower thoracic and lumbar segments; only 13 cases have been reported of DAVF at the foramen magnum. We present three surgically treated patients with DAVF at the foramen magnum. In none of our three patients could the site of the arteriovenous fistula be suspected from the clinical presentation. The clinical course varied from acutely developing signs and symptoms to a 10-year history of very slowly progressing symptoms. After neuroradiological diagnosis the patients were operated on direct microsurgical disconnection of the arteriovenous shunt via an enlargement of the foramen magnum and a hemilaminectomy of C1. DAVF at the foramen magnum may thus present with slowly to acutely progressing clinical symptoms and signs. Spinal angiographic examination should include the level of the foramen magnum if standard spinal angiography of thoracic, lumbar, and sacral segments is negative in suspected spinal DAVF since the nidus of the shunt can be situated remote from the level of neurological disorder. DAVF at the foramen magnum can be treated very effectively and with minimal surgical trauma by direct microsurgical disconnection of the shunt. This surgical procedure is indicated if embolization with glue is not possible or is unsuccessful.

Central Nervous System Vascular Malformations↗

PubMed1993

The foramen magnum: the underutilized acoustic window to the posterior fossa.

Visualization of the posterior fossa during neonatal cranial sonography through the anterior fontanelle can at times be limited. To improve visualization of the posterior fossa, the foramen magnum was used as an acoustic window. Scans through the foramen magnum were obtained in addition to routine scans via the anterior fontanelle in 21 preterm infants. A subjective and retrospective evaluation was performed comparing clarity and definition of posterior fossa structures using the anterior fontanelle and foramen magnum. Images of the fourth ventricle, pons, vermis, cerebellar hemispheres, and cisterna magna were considered superior in clarity and definition when obtained via the foramen magnum. The tentorium was visualized equally well with both windows. Foramen magnum scanning demonstrated improved clarity of two Dandy-Walker variants in comparison to anterior fontanelle scanning. The use of the foramen magnum in addition to other acoustic windows can improve perceived clarity and definition of posterior fossa structures and aid in the detection of abnormalities and anomalies occurring in this location.

Cerebellum↗

PubMed2003

Peak systolic and diastolic CSF velocity in the foramen magnum in adult patients with Chiari I malformations and in normal control participants.

BACKGROUND AND PURPOSE: Abnormal flow of CSF through the foramen magnum has been implicated in the pathogenesis of clinical deficits in association with Chiari I malformation. The purpose of this study was to test the hypothesis that peak CSF velocities in the foramen magnum are increased in patients with Chiari I malformations. METHODS: Eight adult patients with symptomatic Chiari I malformations and 10 adult volunteers were studied with cardiac gated, phase-contrast MR imaging in the axial plane at the foramen magnum. The spatial uniformity of flow velocity in the foramen magnum was assessed at 14 time frames within the R-R interval. The velocity in each of the voxels at each of the time frames was calculated, and the peak systolic and diastolic velocities were tabulated for the patients and controls. RESULTS: For the normal volunteers, the CSF velocities in the subarachnoid space were relatively uniform throughout the subarachnoid space at each of the time frames. Peak systolic velocity ranged from 1.2 to 3.3 cm/s, and peak diastolic velocity ranged from 1.6 to 4.5 cm/s. In symptomatic patients with Chiari I, velocities in the foramen magnum did not appear as uniform throughout the subarachnoid space in the phase-contrast images. Peak systolic velocities ranged from 1.8 to 4.8 cm/s, and peak diastolic velocities ranged from 2.5 to 5.3 cm/s. Peak systolic velocity was significantly higher (P =.01) in the patients than in the control volunteers. CONCLUSION: Patients with Chiari I malformations have significant elevations of peak systolic velocity in the CSF in the foramen magnum.

Adult↗

PubMed1993

Foramen magnum decompression with removal of the outer layer of the dura as treatment for syringomyelia occurring with Chiari I malformation.

The surgical results of foramen magnum decompression in seven patients with syringomyelia associated with Chiari I malformations are reported. The patients were two men and five women, ranging in age from 23 to 54 years (mean, 30 yr). A bony foramen magnum decompression combined with the removal of the outer layer of the dura mater was performed in seven patients. In an average postoperative follow-up period of 2 years (range, 1-3 yr), neurological symptoms and signs improved in six of seven patients and were unchanged in one patient. Postoperative magnetic resonance imaging scans taken a few weeks after surgery showed a decrease in the size of the syrinx or a disappearance of the syrinx in five of seven patients; a few months were required for a similar reduction in the remaining two patients. In all seven patients, the decompression of the foramen magnum proved to be sufficient, as disclosed by postoperative magnetic resonance imaging. Foramen magnum decompression by our surgical technique is advantageous because all the procedures are extradural and there are, therefore, fewer postoperative complications than the foramen magnum decompression techniques previously reported. Foramen magnum decompression by the authors' surgical technique is effective as the initial surgical treatment for syringomyelia associated with Chiari I malformations.

Adult↗

PubMed2006

Human osseous intervertebral foramen width.

Alterations of the width of the human intervertebral foramen can play a pathophysiological role in low back pain. Osseous dimensions of the human intervertebral foramen are rarely recorded. Therefore, we present reference data obtained from skeletal samples of known lifestyle, population affinity, sex, and age at death. Cervical, thoracic, and lumbar vertebrae of functional transition zones of 71 macroscopically normal spines from early 19th century AD Swiss burial sites were selected. The intervertebral foramen widths (IFW) were analyzed with respect to possible lateralization and the impact of sex, individual age, and stature. Neither a significant side difference nor a correlation of IFW with individual age or stature could be found. Females show somewhat larger IFW than males, especially in the lumbar region. Data comparisons with earlier studies are limited due to methodological differences and possible interpopulational variations. Furthermore, the osseous intervertebral foramen only reveals a glimpse of the clinically relevant in vivo structure. Nevertheless, more focus on the osseous dimensions of the intervertebral foramen will provide baseline data of this important anatomical landmark. These data could also explore the peculiarities of the intervertebral foramen, such as its reverse sex dimorphism.

Adult↗

PubMed2002

[The sublabral foramen. Congenital or an acquired variance?].

The sublabral foramen is considered to be a clinically asymptomatic, isolated variant of the anterior-superior capsulo-labral-complex. It may be observed during shoulder arthroscopy and may implicate problems in differential diagnosis of traumatic lesions. In an anatomic study on 89 macroscopically healthy shoulder specimens the age distribution and the incidence in relation to the varying shape of the glenoid as feasible factors of influence for a sublabral foramen (SF) were analyzed in order to elucidate the unknown pathogenesis of SF. In addition histologic sections of three SF samples were obtained. Mean age of the specimens with a sublabral foramen [n=20; 69 (37-84) years] was significantly higher (p=0.04) compared to samples without a sublabral foramen [n=69; 59 (18-94) years]. An increased incidence of a sublabral foramen in relation to a distinct shape of the glenoid could not be established although a prevalence of a glenoid with anterior notch was observed. The results indicate an age-related development of the sublabral foramen,thus in younger patients with an anterior-superior capsulolabral displacement local signs of trauma and involvement of the biceps anchor should be controlled before definitive diagnosis.

Adolescent↗

PubMed2003

The anatomy of the carotico-clinoid foramen and its relation with the internal carotid artery.

The carotico-clinoid foramen is the result of ossification either of the carotico-clinoid ligament or of a dural fold extending between the anterior and middle clinoid processes of the sphenoid bone. It is anatomically important due to its relations with the cavernous sinus and its content, sphenoid sinus and pituitary gland. In this study the ossification state of the carotico-clinoid ligament, the diameter of the internal carotid artery and the carotico-clinoid foramen has been studied on 50 autopsy cases. Of the 100 carotico-clinoid foramina examined, in 27 sides (15 right, 12 left) the carotico-clinoid ligament was completely ossified, in 18 sides (9 right, 9 left) the carotico-clinoid ligament was incompletely ossified and in 55 sides (26 right, 29 left) it was a ligamentous structure. The correlation of the dimensions of the carotico-clinoid foramen and the internal carotid artery showed no statistical significance, except between the carotico-clinoid foramen with a fibrous carotico-clinoid ligament and the internal carotid artery on the right side (p=0.007, r=0.51). The existence of a bony carotico-clinoid foramen may cause compression, tightening or stretching of the internal carotid artery. Further, removing the anterior clinoid process is an important step in regional surgery; the presence of a bony carotico-clinoid foramen may have high risk. Therefore, detailed knowledge of the type of ossification between the anterior and middle clinoid processes can be necessary to increase the success of regional surgery.

Adolescent↗

PubMed2001

The calibre of the foramen of Panizza in Crocodylus porosus is variable and under adrenergic control.

The foramen of Panizza is located within the outflow tract of the crocodilian heart, between the left and right aortas. It has been suggested that the foramen of Panizza has a variable calibre, which could explain the profound changes in the distribution of flows and pressure profiles recorded in the right and left aortas. We investigated this possibility using a modified in-situ perfused heart preparation in combination with isolated strip preparations from the outflow tract. In the perfused heart preparation, bolus injections of adrenaline increased the resistance in the foramen of Panizza, indicating a decrease in its diameter. Isolated strip preparations from the outflow tract showed a concentration-dependent increase in tension in response to adrenaline, while vasoactive intestinal polypeptide caused a relaxation in adrenaline pre-contracted strip preparations. We propose that an increase in the diameter of the foramen of Panizza may be important during pulmonary to systemic shunts to allow blood to flow from the left to right aorta (reverse foramen flow) in order to supply the carotid and coronary arteries. During non-shunting conditions, a constricted foramen may prevent excess flow from the right to left aorta during diastole.

Alligators and Crocodiles↗

PubMed2005

Secondary prevention after cryptogenic cerebrovascular events in patients with patent foramen ovale.

BACKGROUND: Patients with patent foramen ovale and cryptogenic stroke are at risk of recurrence, but there are few data on strategies to prevent this. METHODS: We studied 280 consecutive patients with cryptogenic cerebrovascular events and a patent foramen ovale examined by multiplane transesophageal echocardiography. Patients received platelet inhibitors (n = 66) or anticoagulation (n = 47) or underwent device closure (n = 167). During the mean follow-up of 2.6 years, we compared the frequency of recurrent events, death and severe treatment complications. RESULTS: A total of 33 (12%) patients had a recurrent cerebrovascular event. The annual recurrence rates were 13% in patients treated with platelet inhibitors, 5.6% in those on oral anticoagulation, and 0.6% in those after device closure. Independent predictors of recurrent cerebrovascular events were a patent foramen ovale larger than 4 mm (hazard ratio 3.8, 95% CI 1.2-11.2; p = 0.017) or previous strokes (hazard ratio 4.3, 95% CI 2.0-9.2; p < 0.001). Interventional closure of the patent foramen ovale decreased the risk of a recurrent event compared with oral anticoagulation (hazard ratio 0.06, 95% CI 0.12-0.29; p < 0.001), whereas antiplatelet therapy showed a trend to an increased risk (hazard ratio 2.3; 95% CI 0.9-5.5; p = 0.055). Major side effects occurred in 7 anticoagulated patients and in 13 patients after device closure. There were two non-vascular deaths and one fatal hemorrhagic stroke. CONCLUSIONS: Patients with a large patent foramen ovale and a cryptogenic cerebrovascular event had a substantial risk of recurrence even with medical treatment. Risk of recurrence was lower after device closure of the patent foramen ovale.

Adult↗

PubMed2000

The association between the diameter of a patent foramen ovale and the risk of embolic cerebrovascular events.

PURPOSE: We sought to determine whether the size of a patent foramen ovale affected the risk of embolic cerebrovascular events of unknown origin. PATIENTS AND METHODS: We ascertained the presence and measured the size of patent foramen ovale using multiplane transesophageal echocardiography in 121 consecutive patients younger than 60 years who had transient ischemic attacks or ischemic strokes and in 123 control subjects. None of the patients had left heart, aortic, or carotid sources of embolism, or echocardiographic signs of elevated left or right atrial pressure. We used multivariate logistic regression to determine whether the size of the patent foramen ovale was an independent risk factor for cerebrovascular events. RESULTS: The mean (+/- SD) diameter of a patent foramen ovale was significantly larger in patients (4 +/- 2 mm) than in control subjects (2 +/- 1 mm, P <0.0001). A patent foramen ovale greater than 4 mm was associated with an increased risk of transient ischemic attacks [odds ratio (OR) = 3.4; 95% confidence interval (CI), 1.0 to 11, P = 0.04], ischemic strokes (OR = 12; 95% CI, 3.3 to 44, P = 0.0001), and, especially, having evidence of two or more strokes (OR = 27; 95% CI, 4.7 to 160, P = 0.0002). CONCLUSION: The diameter of a patent foramen ovale is an independent risk factor for ischemic events, especially recurrent strokes.

Adult↗

PubMed2003

Understanding stress concentration about a nutrient foramen.

We investigated the microstructural basis of a reduced stress concentration around the primary nutrient foramen of the equine third metacarpus. We quantified the spatial variations of compositional parameters (mineral content, volume fraction, histological architecture, and osteonal trajectories) from microradiographs and polarizing microscopic images of thin sections. These variations in composition and organization in turn cause variations in mechanical properties of cortical bone. We modeled the spatially inhomogeneous anisotropic elastic properties based on the measured compositional parameters and used the properties as inputs to a finite element model of the bone containing the foramen. This model, spatially constructed solely from the microscopic images, was subsequently validated by our mechanical test results. We found that: (1) a primary mechanism for stress concentration reduction appears to be due to an increased compliance near the foramen: the sharp discontinuity represented by the hole is softened by embedding it in a compliant region; (2) a reinforcing ring of increased stiffness exists at some distance from the foramen; and (3) a ring of lamellar bone exists along the foramen inside edge, which might serve to reduce the chance of cracks forming there. Our work is allowing us to design biomimetic structures with holes by mimicking the microstructure near the nutrient foramen.

Animals↗