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Electroencephalogram (EEG)
Published in Alan Weiss, The Electroconvulsive Therapy Workbook, 2018
There are four essential anatomical landmarks on the human head used to determine the precise position of the EEG electrodes. The nasion is the intersection of the frontal bones and two nasal bones, a distinct depressed area directly between the eyes on the forehead; the inion is the midline bony prominence that is the tip of the external occipital protuberance at the back of the head and the tragus of both left and right ears. The inter
Sleep research recording methods
Published in Philip N. Murphy, The Routledge International Handbook of Psychobiology, 2018
To identify the placement location for each EEG sensor, standardized transcranial measurements are made using the International 10–20 system (Iber, Ancoli-Israel, Chesson, & Quan, 2007; Jasper, 1958). Precise locations are identified using skull landmarks: from the nasion (bridge of the nose) to the inion (base of the occipital protuberance), and then from the left to right preauricular points (posterior root of the zygomatic arch, immediately anterior to the upper end of the tragus). With these two measurements, the central zenith, or center point, of the head is identified; from there, 10% and 20% increments are used to identify each sensor site. The principle behind the 10–20 system is that it ensures consistent placement regardless of head size, shape, or symmetry, and it theoretically avoids sensor placement atop the thicker skull of the cranial sutures.
Placement of leads for the sleep study
Published in Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam, Clinical Atlas of Polysomnography, 2018
Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam
First, identify the nasion on the front of the face. Nasion is the depressed area on the top of the nose and between the eyes where it meets the frontal bone (Figure 6.2). Second, identify the inion at the backside of the lowermost part of skull. Run your finger from the back of head towards the neck in the median plane. You will feel a protuberance here. This is the inion (Figure 6.3). Using a non-elastic measuring tape, measure the distance between these two points. Suppose this distance is 34 cm. Now, calculate the following:
The clinical application of transcranial direct current stimulation in patients with cerebellar ataxia: a systematic review
Published in International Journal of Neuroscience, 2021
Graziella Orrù, Valentina Cesari, Ciro Conversano, Angelo Gemignani
More recently, Benussi et al. [24], investigated whether a 2-week treatment with anodal cerebellar tDCS and spinal cathodal tDCS could reduce clinical symptoms in patients with neurodegenerative ataxia. Twenty-one patients were enrolled and randomized to receive sham or active stimulation. The anode was placed over cerebellar area (anode placed 2 cm under the inion) and the cathode over the spinal lumbar enlargement. Compared to sham stimulation, cerebello-spinal tDCS showed a significant Time × Treatment interactions at different time points (post-stimulation, 1-month and 3-month follow-ups) in SARA (partial η2 = 0.68), ICARS (partial η2 = 0.64), 9HPT in both dominant hand (partial η2 = 0.32) and non-dominant hand (partial η2 = 0.208) and 8 MW (partial η2 = 0.34). Notably, this study suggests that patients who were less impaired showed the greatest improvement for a long-term period (at least 3 months).
Posterior Fossa Decompression and superficial durotomy rather than complete durotomy and duraplasty in the management of Chiari 1
Published in Neurological Research, 2021
Adem Aslan, Usame Rakip, Mehmet Gazi Boyacı, Serhat Yildizhan, Serhat Kormaz, Emre Atay, Necmettin Coban
The patient was positioned on the operating table in the prone position with the help of a nail head. Then, routine perioperative preparations were made and the bone structures between the inion and the second cervical vertebra (C2) were opened. In the preoperative stage, the planum nuchale was measured with the help of CT. It turned towards the cerebellum and compressed it at a sharp angle under the occipital bone, especially the linea nuchae inferior. Decompression was performed accordingly under a microscope. Then, laminectomy was performed on the first cervical vertebra (C1). Ligaments and other structures attached to the dura mater were removed. Later, a vertical incision was made only in the periosteal layer without a full incision of the dura mater, and thus the dura mater was seen to stretch. Then, each layer was closed following the anatomical structure (Figure 2, Video 1). Although this value varies from patient to patient, it is generally between 2 and 3 cm in both vertical and horizontal planes.
Recrudescence of the syringomyelia after surgery of Chiari malformation type 1 with duraplasty
Published in British Journal of Neurosurgery, 2020
All patients underwent surgery in the prone position with their head fixed in a Mayfield head holder. A midline incision was made from the inion to C2 and dissection was performed to expose the occiput and C2. A 5 cm midline skin incision was centered 1 cm above the craniocervical junction. A small suboccipital craniectomy 2 cm in length and 2–3 cm wide was made. The rim of the foramen magnum was decompressed, then, the dura was opened in a ‘Y’ fashion and stitched to the periosteum of the occiput, a C1 laminectomy and duraplasty with artificial dura substitute (Case 1) or fascia lata were performed under the microscope. In all patients, the arachnoid was incised and resected, and cerebrospinal fluid (CSF) drained. Tonsillar sub-pial cauterization and resection of the outer and medial surface of tonsils without affecting intracranial vessels was done as described.5