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Growth of the Cranial Base HHiH
Published in D. Dixon Andrew, A.N. Hoyte David, Ronning Olli, Fundamentals of Craniofacial Growth, 2017
An illustration of this (and of the other fossae) is seen in Figure 11.17. Considering sagittal growth, Melsen (1972) noted growth in the sphenofrontal suture only up to the 7th year of life. Lang (1983) gave measurements of anterior fossa length (lateral to the midline), from the intracranial aperture of the optic foramen to the rounded anterior border of the anterior fossa — 29.31 mm mean length at birth to 42.83 mm at 9 years, to 47.7 mm in the adult. It is uncertain just what contribution the sphenofrontal suture (a part of the “coronal ring” suture system, Bertelsen, 1958; Burdi et al., 1986, 1991) makes, since at the anterior point there is endocranial resorption on the frontal bone (Enlow, 1968, 1986), and at its posterior extent the optic canal is growing backwards with the growth of the jugum sphenoidale and the anterior clinoid process. It seems certain that the anterior fossa has ceased growth by 10 years at the latest (Hoyte, 1989).
Cardiovascular
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
The cavernous segment exits medially to the anterior clinoid process. The anterior choroidal artery arises distally to the posterior communicating artery and proximally to the bifurcation into middle and anterior cerebral arteries.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The centrally-located ethmoid bone is a light, spongy bone (ethmos = “sieve,” and thus ethmoid means “sieve-like”) that acts rather like a keystone anchoring the cranial bone with the facial bones. The intricate and vaguely rectangular ethmoid bone includes the crista galli and cribriform plate—with foramina for bundles of the olfactory nerve (CN I) (Plate 3.2). From the same superior view of the cranial base that shows the ethmoid, one can see that the sphenoid bone includes the lesser wing, anterior clinoid process, greater wing, carotid groove (for the internal carotid artery), and the sphenoid body, which comprises the jugum, chiasmatic (optic) groove, and the sella turcica (tuberculum sellae, hypophyseal fossa, dorsum sellae, and posterior clinoid process) (Plates 3.11 and 3.12). The sphenoid bone also encloses the optic canal—for optic nerve (CN II) and ophthalmic artery; the superior orbital fissure—for oculomotor nerve (CN III), trochlear nerve (CN III), ophthalmic nerve (CN V1), abducens nerve (CN VI), and superior ophthalmic vein; the foramen rotundum—for maxillary nerve (CN V2); foramen ovale—for mandibular nerve (CN V3); and the foramen spinosum—for middle meningeal artery and vein (Plate 3.2). Note that the foramen lacerum lies between the sphenoid and temporal bones, the anterior cranial fossa is separated from the middle cranial fossa by the sphenoidal crests and limbus, and the posterior cranial fossa is also separated from the middle cranial fossa by the superior border of the petrous part of the temporal bone and by the dorsum sellae. On the medial wall of the orbit between the sphenoid and the frontal bones lie the anterior ethmoidal foramen and the posterior ethmoidal foramen through which pass the anterior and posterior ethmoidal arteries, veins, and nerves, respectively. The part of the ethmoid bone that forms the medial aspect of the orbit is so thin that is called the lamina papyracea (“papyrus,” the thin plant-derived paper; “lamina” means layer).
Surgical clipping of ophthalmic artery aneurysms: a single center series
Published in British Journal of Neurosurgery, 2021
Donglin Lu, Jing Xiong, Hengjian Liu, Han Zhou, Jing Cheng, Yong Yue, Huawei Zhang, Xujin Yao, Jinyang Ren, Yugong Feng
Retracting the optic nerve near during surgery risks visual field loss and retraction is minimized by cutting the falciform ligament to mobilise the nerve. Opening the dural ring of the internal carotid artery and drawning the dura mater towards the orbital roof can fully expose the internal carotid artery, OphA and aneurysm neck. This allows for clipping without removing the anterior clinoid process (Figure 1). If the artery or aneurysm neck cannot be fully separated from the optic nerve, removing the anterior clinoid process is necessary to increase the exposure of the anterior edge of the aneurysm neck (Figure 1). Continuous washing with cool physiological saline during the process of drilling the anterior process and the apex of optic canal protects the optic nerve, internal carotid artery and other structures from heat damage. Epidural or epidural combination methods can also be used to remove the anterior clinoid process.9 Some studies have shown that the ultrasonic osteotomy is safer in the treatment of the anterior process.10
Atypical location of unusual supratentorial neurenteric cyst: a case report
Published in British Journal of Neurosurgery, 2019
Ramanadha Reddy, Mahesh Kumar, Suchanda Bhattacharjee
Neurenteric cysts (NEC) are rare, benign developmental lesions thought to derive from endodermal epithelium which can occur anywhere along the neuraxis but are most commonly present in the spine. Intracranial NEC are rare, accounting for 1/4 of all NEC’s. Almost 3/4 of these occur in the posterior fossa and almost all are extra-axial.1 All reported supratentorial NEC are off-midline and most are adjacent to the frontal lobes.1 They typically present in children and young adults. We present an unusual case of a 55-year old man who complained of headache and gradual impairment of vision in the right eye. He was found to have right anterior clinoid process (ACP) erosion with compression of the cisternal portion of right optic nerve on computed tomography (CT). MRI showed a non-enhancing lesion that was hyperintense on T1, and T2 with a differential diagnoses of epidermoid cyst, abscess and neuroenteric cyst. In view of visual deterioration surgery was conducted.
Paranasal sinus mucocele with visual disturbances whose causative legion was hardly identified on computed tomography imaging: A case report
Published in Acta Oto-Laryngologica Case Reports, 2019
Yu Mizushima, Takashi Mumo, Takuya Yasui, Ken Ito
Two days later, again the patient visited our hospital since his left vision dropped further to as low as light perception. MRI with gadolinium contrast of paranasal sinuses was performed. MRI revealed a cystic lesion around left anterior clinoid process which was adjacent to the left optic canal (Figure 2). The lesion was considered as sinus mucocele because it was T2-hyperintense, T1-isointense and gadolinium-contrast enhanced only its margin. Emergency endoscopic sinus surgery was performed by the otolaryngologists. Both the sinus cyst and left optic nerve canal were opened to avoid the risk of relapse (Figure 3). The cyst was unilocular and lined with mucosa containing slight purulent content. The culture of mucocele content was positive for Staphylococcus epidermidis and Staphylococcus capitis.