Biomechanics and Tissue Injuries
Rolland S. Parker in Concussive Brain Trauma, 2016
As quoted by Erin D. Bigler in the previous edition, “Oftentimes injury to the temporal lobe occurs because of its impact against the lesser sphenoidal wing. The sphenoid bone surrounds much of the medial undersurface and the anterior aspect of the temporal lobe. With high-velocity impact or rapid acceleration/deceleration the temporal lobe moves about in the middle cranial fossa. The movement of the temporal lobe impacting against the sphenoid is the basis of compression of temporal lobe structures against bone and also the temporal lobe may glide along or over the sphenoid, which may cause contusion and/or shearing effects. As illustrated in the CT imaging presented in this figure, this child ends up with significant temporal lobe contusion most probably related to the direct impact effect of the temporal lobe against the sphenoid (see Figures 6.6a and 6.6b). In clinical neuropsychology, it is likely that many of the memory and emotional changes that accompany TBI are related to damage produced by the temporal lobe coming into contact with the sphenoid and disrupting mesial temporal lobe structures including subcortical structures such as the amygdala and hippocampus that sit just inside the parahippocampal gyrus and just above the fusiform gyrus.”
Neuro-ophthalmology
Mostafa Khalil, Omar Kouli in The Duke Elder Exam of Ophthalmology, 2019
CNII is formed by the convergence of retinal ganglion cell axons. The nasal axons of CNII correspond to the temporal visual field, while the temporal axons correspond to the nasal visual field. CNII has four parts: Intraocular (shortest; 1 mm): Exits posteriorly via the lamina cribrosa (scleral opening).Intraorbital (longest; 25 mm): Has myelinated covering. Ends at the optic foramen.Intracanalicular: Where the optic nerve exits the orbit through the optic canal to enter the middle cranial fossa.Intracranial: Ends at the optic chiasm.
Head and Neck
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
On the internal aspect of the skull, the temporal bone includes the squamous part and the petrous part (“stony” or “hard”). This petrous part includes the groove for the greater petrosal branch of the facial nerve, the groove for the lesser petrosal nerve, the tegmen tympani (portion of floor of middle cranial fossa), the groove for the sigmoid sinus, the internal acoustic meatus for the passage of the facial nerve (CN VII) and the vestibulocochlear nerve (CN VIII). Between the temporal bone and the occipital bone lies the jugular foramen for the passage of the glossopharyngeal nerve (CN IX), vagus nerve (CN X), accessory nerve (CN XI), and sigmoid sinus (Plates 3.11 and 3.12).
Paediatric orbital conjunctival epithelial cyst with positive asialotransferrin
Published in Orbit, 2020
Rukaiya Malik, James English, Thomas G. Hardy
The CT scan of the orbits was reviewed by neuroradiologists and neurosurgeons together and it was assessed that there was no intracranial connection to the orbital cyst. Rather, there was thinning of the sphenoid bone secondary to remodeling from the adjacent cyst (Figure 4). Subsequently, the patient underwent complete resection of the cyst, with no damage to the cystic wall or other structures. She had an unremarkable post-operative recovery and her BCVA on day one post-operative improved to 6/7.5 in the left eye. The MRI and fine cut CT brain images were re-reviewed by a pediatric neuro-radiologist following the case completion. It was assessed that the clinical significance of the middle cranial fossa is indeterminate and hence a follow up MRI was recommended which is still to be conducted.
Internal maxillary artery to middle cerebral artery bypass for a complex recurrent middle cerebral artery aneurysm: case report and technical considerations
Published in British Journal of Neurosurgery, 2022
Ronan J. Doherty, Daragh Moneley, Paul Brennan, Mohsen Javadpour
Preoperatively the patient underwent computed tomographic angiography (CTA) of the head which was used for intraoperative navigation and localisation of the IMAX (Figure 2). Under general anaesthesia, the patient was positioned supine, with the head in the Mayfield head holder and rotated approximately 45 degrees towards the contralateral side. The previous left frontotemporal incision and pterional craniotomy were reopened. The temporalis muscle was reflected inferiorly and a zygomatic arch osteotomy was performed. Under the operating microscope, a temporal fossa craniectomy was performed consisting of removal of bone of the lateral part of middle cranial fossa floor extending medially as far as a line connecting the foramen rotundum and foramen ovale (Figures 3 and 4). The left IMAX was localised in the infratemporal fossa using a combination of CTA-based neuronavigation and micro-Doppler probe (Mizuho Inc. Tokyo, Japan) (Figure 5). In addition, the deep temporal arteries in the deep aspect of the temporalis muscle were followed proximally to lead to the location of the IMAX.
Cavernous sinus haemangioma masquerading as a pituitary macroadenoma: how the unexpected lurks in neurosurgery
Published in British Journal of Neurosurgery, 2023
Simon Lammy, Jennifer Brown, Patricia Littlechild
Common locations include the middle cranial fossa, pituitary fossa, optic chiasm, cavernous sinus, Vth and VIIth cranial nerves, cerebello-pontine angle and ventricles.1–3 Therefore, symptoms include headache, and those attributable to cavernous sinus and chiasmal syndromes.2–5 Signs are insidious due to their quiescent nature5 and include ptosis1,2, diplopia1,2, decreased visual acuity, visual field defects, obesity, amenorrhoea and facial numbness and neuralgia due to Gasserian ganglion involvement.2,4 Further anatomical sub-locations include Parkinson’s triangle between IVth and V1 and Mullan’s triangle between V1 and V22. This contrasts CCMs that usually present in a haemorrhagic fashion (25%) displaying both focal neurological deficits and seizures. Less than 1% of CSH present as a haemorrhage despite being highly vascular.1–5
Related Knowledge Centers
- Anterior Cranial Fossa
- Petrous Part of The Temporal Bone
- Posterior Cranial Fossa
- Skull
- Sphenoid Bone
- Temporal Bone
- Temporal Lobe
- Pituitary Gland
- Clivus
- Petrous Part of The Temporal Bone
- Anterior Clinoid Process