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Cranial Nerve 10

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9701. Waterjet dissection of the vestibulocochlear nerve: an experimental study. Full Text available with Trip Pro

Waterjet dissection of the vestibulocochlear nerve: an experimental study. Waterjet dissection has been shown to protect intracerebral vessels, but no experience exists in applying this modality to the cranial nerves. To evaluate its potential, the authors examined waterjet dissection of the vestibulocochlear nerve in rats.Lateral suboccipital craniectomy and microsurgical preparation of the vestibulocochlear nerve were performed in 42 rats. Water pressures of 2-10 bar were applied (...) analysis of the ABR demonstrated complete functional nerve preservation up to 6 bar after 6 weeks in all rats. Waterjet dissection with 8 bar was associated with a 60% recovery of ABR. In the 10-bar group, no recovery was seen.Microsurgical dissection of cranial nerves is possible using waterjet dissection while preserving both morphology and function. The aforementioned jet pressures are known to be effective in neurosurgical treatment of tumors. Thus, waterjet dissection may be useful in skull base

2008 Journal of Neurosurgery

9702. Histological considerations of the cleavage plane for preservation of facial and cochlear nerve functions in vestibular schwannoma surgery. (Abstract)

nerve fibers can be identified intraoperatively. Conversely, when a severe adhesion between the tumor and facial or cochlear nerve fibers is observed, dissection of the vestibular nerve-tumor interface (the subcapsular or subperineurial dissection) is recommended for preservation of the functions of these cranial nerves. (...) Histological considerations of the cleavage plane for preservation of facial and cochlear nerve functions in vestibular schwannoma surgery. The authors analyzed the tumor capsule and the tumor-nerve interface in vestibular schwannomas (VSs) to define the ideal cleavage plane for maximal tumor removal with preservation of facial and cochlear nerve functions.Surgical specimens from 21 unilateral VSs were studied using classical H & E, Masson trichrome, and immunohistochemical staining against

2008 Journal of Neurosurgery

9703. Magnetic resonance angiography and clinical evaluation of third nerve palsies and posterior communicating artery aneurysms. (Abstract)

Magnetic resonance angiography and clinical evaluation of third nerve palsies and posterior communicating artery aneurysms. The authors conducted a study to determine the utility of the clinical profile and magnetic resonance (MR) angiography in evaluating patients with isolated third cranial nerve palsies or posterior communicating artery (PCoA) aneurysms.Three-dimensional time-of-flight MR angiography was performed in a consecutive series of patients with isolated acute third cranial nerve (...) palsy not due to a ruptured aneurysm and in patients with unruptured PCoA aneurysms. A neuroradiologist, masked to the identities of the patients, interpreted reformatted maximum intensity projection (MIP) and source images of the PCoAs and aneurysms. The investigators assessed clinical features of oculomotor nerve dysfunction and focal head pain. Cases involving cranial third nerve palsy without aneurysms were classified as Group 1 (no case entailed catheter-based angiography), and cases involving

2006 Journal of Neurosurgery

9704. Bilateral vidian nerve schwannomas associated with facial palsy. Case report and review of the literature. (Abstract)

Bilateral vidian nerve schwannomas associated with facial palsy. Case report and review of the literature. Intracranial schwannomas are relatively common benign tumors arising from Schwann cells. Among the cranial nerves, the vestibular division of the vestibulocochlear nerve is the site most commonly affected by these lesions, followed by the trigeminal nerve. The authors report a case of bilateral schwannomas arising from both of the pterygoid canals. A 13-year-old girl presented

2006 Journal of Neurosurgery

9705. Split facial nerve course in vestibular schwannomas. Full Text available with Trip Pro

to the brainstem up to the level of the trigeminal root exit zone and crossed on the cranial tumor pole to the internal auditory canal. The two nerve portions rejoined at the level of the porus acusticus. The smaller portion carried fibers exclusively to the orbicularis oris muscle, whereas the major portion supplied all three branches of the facial nerve.In VSs, an aberrant course with distinct splitting of the facial nerve adds considerably to the surgical challenge. Long-term facial nerve results (...) Split facial nerve course in vestibular schwannomas. The facial nerve in vestibular schwannomas (VSs) is located on the ventral tumor surface in more than 90% of cases; other courses are rare. A split facial nerve course with two distinct bundles has thus far been described exclusively for medial extrameatal tumors.Between 1996 and 2005, 16 consecutive cases of 241 surgically treated VSs were observed to have distinct splitting of the facial nerve. The mean tumor size measured 27 mm. In one

2006 Journal of Neurosurgery

9706. Entrapment neuropathy of the optic nerve due to hyperostosis associated with congenital anemia. Full Text available with Trip Pro

Entrapment neuropathy of the optic nerve due to hyperostosis associated with congenital anemia. The authors report on the case of a 14-year-old boy who presented with bilateral visual impairment due to optic canal stenosis caused by hyperplasia of the bone marrow arising from anemia. The patient had hereditary hemolytic anemia with unstable hemoglobin of the Christchurch type. This congenital form of anemia caused hyperplasia of the bone marrow as well as hyperostosis of the entire calvarial (...) bone, which in turn led to optic canal stenosis. The patient underwent surgical decompression of the optic canal, resulting in significant improvement in visual acuity. Pathological findings in the calvarial bone indicated hypertrophic bone marrow with no other specific features such as neoplastic pattern or fibrous dysplasia. With the exception of objective hearing impairment, no other significant cranial neuropathy has been detected thus far. On reviewing the published literature, this case

2005 Journal of Neurosurgery

9707. Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve. (Abstract)

an atypical location of a synovial cyst with cranial nerve involvement. (...) Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve. An unusual case of an intraneural ganglion cyst of the hypoglossal nerve is presented. Only one case of this rare clinical entity has been reported previously. A 51-year-old woman presented with a 6-month history of left-sided hypoglossal nerve palsy. Magnetic resonance imaging revealed a cystic lesion related to the hypoglossal canal. There was no enhancement of the lesion after administration

2005 Journal of Neurosurgery

9708. Motor neuronal and glial apoptosis in the adult facial nucleus after intracranial nerve transection. (Abstract)

explicitly demonstrated after peripheral cranial nerve transection in adult mammals.The authors induced substantial retrograde neuronal death in the adult rodent by transecting the facial nerve during its intracranial course. Neuronal apoptosis was demonstrated as shrunken facial motor neurons, retrogradely labeled with fluorogold and with nuclei positively labeled by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL). Glial apoptosis was demonstrated (...) Motor neuronal and glial apoptosis in the adult facial nucleus after intracranial nerve transection. Intracranial lesions affecting the facial nerve are usually associated with significant morbidity and poor functional restitution, despite the fact that a peripheral nerve injury normally recovers well. Mechanistic explanations are needed to direct future therapies. Although neonatal motor neurons are known to die as a result of apoptosis after axotomy, this cell death mechanism has not been

2006 Journal of Neurosurgery

9709. Paroxysmal otalgia due to compression of the intermediate nerve: a distinct syndrome of neurovascular conflict confirmed by neuroimaging. Case report. (Abstract)

Paroxysmal otalgia due to compression of the intermediate nerve: a distinct syndrome of neurovascular conflict confirmed by neuroimaging. Case report. The authors present the case of a 52-year-old female patient with a 6-year history of intractable paroxysmal otalgia. Preoperative magnetic resonance (MR) angiography demonstrated an anterior inferior cerebellar artery loop compressing the intermediate nerve in the seventh/eighth cranial nerve complex inside the internal auditory canal. The pain (...) resolved completely after a microvascular decompression via a retromastoid craniotomy. To the best of the authors' knowledge, the combined neuroimaging and intraoperative findings of this case provide a unique demonstration that vascular compression of the intermediate nerve can be the exclusive cause of paroxysmal otalgia. Magnetic resonance imaging and MR angiography can establish the causative mechanism and distinguish this otalgia due to vascular compression of the intermediate nerve from other

2007 Journal of Neurosurgery

9710. Neurovascular compression of the abducent nerve causing abducent palsy treated by microvascular decompression. Case report. (Abstract)

Neurovascular compression of the abducent nerve causing abducent palsy treated by microvascular decompression. Case report. Isolated abducent palsy is a symptom that can be caused by many different intracranial pathological conditions. In this report the authors describe the case of a patient who suffered isolated abducent palsy resulting from vascular compression of the sixth cranial nerve; surgical treatment consisted of microvascular decompression (MVD). This 56-year-old man presented (...) with short-lasting episodes of a pulling sensation at the lateral side of his right eye associated with intermittent diplopia, followed by a progressive palsy of the abducent nerve and constant diplopia. Magnetic resonance imaging revealed a neurovascular contact of a dolichoectatic basilar artery with the abducent nerve. The patient underwent surgery consisting of a combined supra- and infratentorial presigmoid approach and subsequent MVD of the abducent nerve. Postoperatively, the abducent nerve palsy

2007 Journal of Neurosurgery

9711. Nerve-identifying inguinal hernia repair: a surgical anatomical study. (Abstract)

herniorrhaphy.Through dissection of 18 inguinal areas of embalmed and unembalmed human cadavers, identification zones were developed for the inguinal nerves (in particular for the genital branch of the genitofemoral nerve).The iliohypogastric nerve was identifiable running approximately horizontally and ventrally to the internal oblique muscle perforating the external oblique aponeurosis at a mean of 3.8 cm (range 2.5-5.5 cm) cranially from the external ring. When present, the ilioinguinal nerve was identifiable (...) Nerve-identifying inguinal hernia repair: a surgical anatomical study. Pain syndromes of somatic and neuropathic origin are considered to be the main causes of chronic pain after open inguinal hernia repair. Nerve-identification during open hernia repair is suggested to be associated with less postoperative chronic pain. The aim of this study was to define clinically relevant surgical anatomical zones facilitating efficient identification of the three inguinal nerves during open

2007 World Journal of Surgery

9712. Contralateral motor rootlets and ipsilateral nerve transfers in brachial plexus reconstruction. (Abstract)

to the suprascapular nerve by using sural nerve grafts. The biceps motor branch or the musculocutaneous nerve was repaired either by an ulnar nerve fascicular transfer or by transfer of the 11th cranial nerve or the phrenic nerve. The mean recovery in abduction was 90 degrees and 92 degrees in external rotation. In cases of total palsy, only two patients recovered external rotation and in those cases mean external rotation was 70 degrees. Elbow flexion was achieved in all cases. In cases of ulnar nerve transfer (...) , the muscle scores were M5 in one patient, M4 in six patients, and M3+ in five patients. Elbow flexion repair involving the use of the 11th cranial nerve resulted in a score of M3+ in five patients and M4 in two patients. After surgery involving the phrenic nerve, two patients received a score of M3 + and two a score of M4. Results were clearly better in patients with partial lesions and in those who were shorter than 170 cm (p < 0.01). The length of the graft used in motor rootlet transfers affected only

2004 Journal of Neurosurgery

9713. Significance of the tentorial alignment in approaching the trigeminal nerve and the ventral petrous region through the suboccipital retrosigmoid technique. Full Text available with Trip Pro

Significance of the tentorial alignment in approaching the trigeminal nerve and the ventral petrous region through the suboccipital retrosigmoid technique. In this study, the authors aimed to identify the factors that would predict the operative distance between the trigeminal nerve (fifth cranial nerve) and the acousticofacial nerve complex (seventh-eighth cranial nerves) preoperatively when approaching the cerebellopontine angle (CPA) through the suboccipital retrosigmoid approach.In 40 (...) the tentorial angle and distance (r = -0.228, p = 0.08). The mean distance was 3.5 +/- 1.9 mm for a tentorial angle less than 51 degrees and 2.7 +/- 1.1 mm for a tentorial angle of at least 51 degrees. No correlation existed between either the petrous or occipital angles and distance.The distance between the trigeminal nerve and acousticofacial nerve complex decreases in the presence of a steep tentorial angle. This limits the operating field between these cranial nerves when reaching the petroclival

2007 Journal of Neurosurgery

9714. Classification of neurovascular compression in typical hemifacial spasm: three-dimensional visualization of the facial and the vestibulocochlear nerves. Full Text available with Trip Pro

causative vessel. The posterior inferior cerebellar artery, vertebral artery, internal auditory artery, and veins at the REZ of the facial nerve (the seventh cranial nerve) were also found to cause vascular contacts to the REZ of the facial nerve. In addition to this, the authors identified three distinct types of NVC within the REZ of the facial nerve at the affected sides. The authors analyzed the varying courses of the vessels on the unaffected sides. There were no bilateral clinical symptoms of HFS (...) Classification of neurovascular compression in typical hemifacial spasm: three-dimensional visualization of the facial and the vestibulocochlear nerves. In this paper, the authors introduce a method of noninvasive anatomical analysis of the facial nerve-vestibulocochlear nerve complex and the depiction of the variable vascular relationships by using 3D volume visualization. With this technique, a detailed spatial representation of the facial and vestibulocochlear nerves was obtained. Patients

2007 Journal of Neurosurgery

9715. Inflammatory myofibroblastic tumor of the ulnar nerve. Case report and review of the literature. Full Text available with Trip Pro

Inflammatory myofibroblastic tumor of the ulnar nerve. Case report and review of the literature. Inflammatory myofibroblastic tumors with involvement of cranial and peripheral nerves are exceedingly rare. The authors present the case of a 67-year-old man with an inflammatory myofibroblastic tumor of the left ulnar nerve, which was identified intraoperatively and mimicked a malignant neoplastic lesion. Histopathological examination revealed loosely structured fibrous tissue and collagen deposits (...) intermingled with patchy infiltrates of lymphocytes, plasma cells, and histiocytes penetrating the endo- and epineurium of the affected nerve fascicles. There was strong expression of vimentin and actin in spindle cells throughout the lesion. The histiocytes were CD68- and major histocompatibility complex class II-positive, but lacked CD1a expression. A review of the literature revealed nine histopathologically confirmed cases of inflammatory myofibroblastic tumors involving peripheral or cranial nerves

2007 Journal of Neurosurgery

9716. Vagus nerve stimulation for induced spinal cord seizures: insights into seizure cessation. (Abstract)

cessation of seizure activity in all study animals.The effects of vagus nerve stimulation on induced spinal cord seizures involve descending spinal pathways. The authors believe that this experiment is the first to demonstrate that spinal cord neuronal hyperactivity can be suppressed by stimulation of a cranial nerve. These data may aid in the development of alternative mechanisms for electrical stimulation in patients with medically intractable seizures. Further studies are now necessary to isolate (...) Vagus nerve stimulation for induced spinal cord seizures: insights into seizure cessation. Vagus nerve stimulation is known to decrease the frequency, duration, and intensity of some types of intracranial seizures in both humans and animals. Although many theories abound concerning the mechanism for this action, the true cause remains speculative. To potentially elucidate a pathway in which vagus nerve stimulation aborts seizure activity, seizures were initiated not in the cerebral cortex

2005 Journal of Neurosurgery

9717. Patients with chronic tension-type headache demonstrate increased mechano-sensitivity of the supra-orbital nerve. (Abstract)

+/-1.58) than controls (0.15+/-0.28) (P<.001). Within the CTTH group, intensity, frequency, and duration of the headaches were negatively correlated with PPT (rsor=0.72; P<.001).These findings reveal that mechanical hypersensitivity is not limited to muscles but also occurs in cranial nerves, and that the level of sensitization, either due to peripheral or central processes, is related to the severity of the primary headache. (...) Patients with chronic tension-type headache demonstrate increased mechano-sensitivity of the supra-orbital nerve. This study aimed to establish whether increased sensitivity to mechanical stimuli is present in neural tissues in chronic tension-type headache (CTTH).Muscle hyperalgesia is a common finding in CTTH. No previous studies have investigated the sensitivity of peripheral nerves in patients with CTTH.A blinded controlled study.Pressure pain thresholds (PPT) and pain intensity following

2008 Headache

9718. Facial nerve palsy after head injury: Case incidence, causes, clinical profile and outcome. (Abstract)

Facial nerve palsy after head injury: Case incidence, causes, clinical profile and outcome. To investigate the case incidence, causes, clinical profile, and outcome of facial nerve palsy complicating head trauma.A 10-year (1991-2000) retrospective study of head injured patients at the University Teaching Hospital, Ilorin, Nigeria. Age, gender, and neurologic findings were analyzed.Of 794 patients, facial nerve palsy occurred in 40 (5.04%). Facial nerve was the most frequently injured cranial (...) nerve, followed by vestibulo-cochlear (12 [1.5%]) and abducens (8 [1.0%]). Majority (70%) of the seventh nerve palsies were of the lower motor neurone type. The left nerve was more frequently affected (60%). Facial nerve palsy was more common in male patients and adults with a peak incidence at the 4th decade. Spontaneous functional recovery occurring within 6 to 24 months of injury was total in 12 (30%), partial in 5 (12.3%), and none in 3 (7.5%) subjects. Thirteen patients died giving a mortality

2006 Journal of Trauma

9719. Controlled, clinical trial assessing saphenous, tibial and common peroneal nerve blocks for the control of perioperative pain following femoro-tibial joint surgery in the nonchondrodystrophoid dog. (Abstract)

Controlled, clinical trial assessing saphenous, tibial and common peroneal nerve blocks for the control of perioperative pain following femoro-tibial joint surgery in the nonchondrodystrophoid dog. To determine whether bupivacaine peripheral nerve block of the saphenous, tibial and common peroneal nerves proximal to the femoro-tibial joint reduces peri-operative pain following extracapsular surgical stabilization of cranial cruciate ligament rupture in the nonchondrodystrophoid dog.Forty-one (...) dogs with naturally acquired femoro-tibial joint instability. Study design Randomized, controlled, clinical trial.Dogs diagnosed with suspected cranial cruciate ligament injury based on physical and radiographic evidence were randomly assigned to treatment (bupivacaine) or control (saline) nerve blocks before femoro-tibial joint surgery. Pain scores, skin sensation, pain threshold to incisional pressure, time to first systemic 'rescue' opioid analgesic and total analgesic dose were evaluated for 24

2006 Veterinary anaesthesia and analgesia Controlled trial quality: uncertain

9720. Donor Nerve Selection in Facial Reanimation Surgery Full Text available with Trip Pro

Donor Nerve Selection in Facial Reanimation Surgery The motor components of local cranial nerves provide a series of options for the surgical rehabilitation of the paralyzed face. Nerve donor sites vary with respect to their motor power, functional deficit, and synergy with facial expression. A thorough understanding of each donor nerve's strengths and weaknesses facilitates the selection process. Technical modifications to reduce donor site morbidity and the emerging role of the masseter nerve

2004 Seminars in plastic surgery

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