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Introduction: Background Material
Published in Nassir H. Sabah, Neuromuscular Fundamentals, 2020
There are several classifications and names for the various brain structures, which is somewhat confusing. Conventionally, the brain may be divided into four major subdivisions, as indicated in Figure 1.7 and are illustrated in Figure 1.8 in a midsagittal section that divides the brain into right and left halves. These two halves of the brain are interconnected by a massive fiber tract, the corpus callosum, having a cross-sectional area of about 700 mm2 and consisting of about 200 million fibers. A smaller tract, the anterior commissure, also connects the two hemispheres. The four major subdivisions will be described very briefly in what follows. More details about the structure of these subdivisions, their substructures, and their functions will be presented in future chapters as needed for our discussion of the neuromuscular system.
Neuroanatomy of basic cognitive function
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
Mark J. Ashley, Jessica G. Ashley, Matthew J. Ashley
Interhemispheric connections are accomplished by the corpus callosum and two smaller commissural bundles. The anterior commissure interconnects the anterior temporal areas. The hippocampal gyri are connected to each other via the hippocampal commissure.
Laryngeal trauma
Published in Declan Costello, Guri Sandhu, Practical Laryngology, 2015
Guri Sandhu, S. A. Reza Nouraei
The main indications for open repair are unstable or comminuted laryngeal fractures, cricotracheal separation, detachment of the anterior commissure or extensive mucosal disruption. For open exploration, a transverse neck incision is placed over the cricoid and the subplatysmal flaps are elevated. Strap muscles are separated in the midline and retracted. In a proportion of patients with unstable laryngeal fractures but with minimal or endoscopically treatable endolaryngeal injuries, a thyrotomy can be avoided. Repair of the anterior commissure, or significant endolaryngeal injuries, is achieved through an anterior vertical laryngofissure. However, a paramedian fracture close to the midline may also be used. Haematomas are evacuated and mucosa tears repaired with 5-0 or 6-0 absorbable sutures. Mucosal loss can often be reconstructed with local mucosal flaps and in particular, posterior commissure injuries can and should be reconstructed with piriform fossa or supraglottic mucosa to prevent laryngeal stenosis. The anterior margins of the vocal folds are attached to the anterior limit of the thyroid cartilage or its outer perichondrium using a slow-absorbing monofilament suture. It is very important to re-establish the appropriate height of the vocal folds to optimise voice outcomes. Thyroid cartilage fractures are repaired using permanent or resorbable miniplates, with at least two points of fixation either side of the fracture line (Figure 9.4). Even in the older patient, the cricoid arch does not fully calcify and can be repaired using suture material alone.
Application of digital modeling and three-dimensional printing of titanium mesh for reconstruction of thyroid cartilage in partial laryngectomy
Published in Acta Oto-Laryngologica, 2022
Hao Tian, Shuichao Gao, Jianjun Yu, Xiao Zhou, Xing Chen, Liang Zuo, Xu Cai, Bo Song, Kun Yu
At present, there is no perfect treatment for LC patients with anterior commissure involvement, concerning both efficacy, and quality of life postoperatively. This may be due to the peculiarity of anterior commissure. The recurrence rate is relatively low because of the extended resection of anterior commissure and thyroid cartilage in open surgery, in which CHEP is a frequent therapeutic method. The advantage of CHEP includes wide indications, high rate of endotracheal intubation, and low recurrence rate of tracheal stenosis. However, aspiration and poor pronunciation are the common disadvantages. Some patients may suffer severe pneumonia because of long-term aspiration with tracheal tube. Thus, it is highly essential to preserve laryngeal function to the greatest extent in case of radical resection to shorten recovery time [5].
Altered dynamic parahippocampus functional connectivity in patients with post-traumatic stress disorder
Published in The World Journal of Biological Psychiatry, 2021
Hui Juan Chen, Rongfeng Qi, Jun Ke, Jie Qiu, Qiang Xu, Zhiqiang Zhang, Yuan Zhong, Guang Ming Lu, Feng Chen
Magnetic resonance imaging scans were conducted at Hainan General Hospital using a 3 Tesla MR scanner (Skyra, Siemens Medical Solutions, Erlangen, Germany) equipped with a 32 channel standard head coil. Subjects’ heads were immobilised using a foam pad and a Plexiglas head cradle. Whole brain resting-state functional images were obtained using an echo-planar imaging sequence with the following parameters: TR/TE = 2000/30 ms, flip angle = 90°, FOV = 230 × 230 mm2, matrix = 64 × 64, 35 slices, slice thickness = 3.6 mm, no intersection gap, and total volume number = 250. The sections were placed approximately parallel to the anterior commissure-posterior commissure line. High resolution T1-weighted 3 D anatomical images were also acquired with a sagittal magnetization-prepared rapid gradient echo sequence for later co-registration and normalisation (TR/TE = 2300/1.97 ms, flip angle = 9°, FOV = 256 × 256 mm2, matrix = 256 × 256, 176 slices, slice thickness = 1 mm). Each fMRI scan lasted for 500 seconds. During the functional scanning, subjects were instructed to lie quietly, keep their eyes closed, and let their mind wander without falling asleep.
Seizure and cognitive outcomes of posterior quadrantic disconnection: a series of 12 pediatric patients
Published in British Journal of Neurosurgery, 2020
Yao Wang, Chao Zhang, Xiu Wang, Lin Sang, Feng Zhou, Jian-Guo Zhang, Wen-Han Hu, Kai Zhang
After this procedure, the fibres mentioned in 1)–3) above were disconnected with remaining fibres as follows: 5) hippocampal efferent fibres; 6) projection fibres from the amygdala; 7) fibres through the anterior commissure between the anterior temporal lobe and limbic cortex; and 8) projection fibres from the insula to the basal ganglia, thalamus, hypothalamus and brain stem.(3) Stage III: Mesial temporal resection: After the opening of the temporal horn, the amygdala was revealed in the anteromedial part. The amygdala was removed along with resection of the subdural uncinate gyrus. The superior boundary of the amygdala resection was located at the top of the temporal horn of the lateral ventricle. The hippocampus was exposed and resected along the temporal horn and choroid fissure.