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Llopis G, Quinones S, Konschake M, Simon De Blas C, Hernández LM, Abramovic A, Viñuela-Prieto JM, Sanudo J, Tubbs RS, Maranillo E. ATHEROMATOSIS OF THE BRAIN-SUPPLYING ARTERIES: CIRCLE OF WILLIS, BASILAR, VERTEBRAL AND THEIR BRANCHES. Ann Anat 2022; 243:151941. [PMID: 35378255 DOI: 10.1016/j.aanat.2022.151941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Atherosclerotic plaques in the brain-supplying arteries are slowly-developing alterations of vascular structures that can lead to neurological impairment due to stenosis and insufficient oxygenation of eloquent brain areas. The aim of this study is to provide detailed demographic information related to the incidence of atherosclerotic plaques in the cerebral arteries. MATERIAL AND METHODS Forty-eight circles of Willis (21 men, 21 women, mean age: 70.26, six samples unknown) were macroscopically analyzed for length, diameter, and presence of atherosclerotic plaques. Statistical analysis was used to identify potential differences in the locations and frequencies of atherosclerotic plaques in relation to age and sex. RESULTS The study sample revealed 261 atherosclerotic plaques. The key findings were significant correlations between plaque development and age and between plaque location and age; however, there was no significant sex difference. CONCLUSION The upper and lower branches of the middle cerebral artery (MCA) were novel locations predisposing to plaque development. A cut-off value at 60 years revealed a significant difference in plaque development and distribution. There were no significant sex differences in the occurrence of atherosclerotic plaques.
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Affiliation(s)
- G Llopis
- Department of Anatomy and Embryology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - S Quinones
- Department of Anatomy and Embryology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - M Konschake
- Institute of Clinical and Functional Anatomy, Medical University of Innsbruck (MUI), Innsbruck, Austria.
| | - C Simon De Blas
- Department of Computer Science and Statistics, Universidad Rey Juan Carlos, Madrid, Spain
| | - L M Hernández
- Department of Human Anatomy and Embryology, School of Medicine, Alcalá University of Madrid, Madrid, Spain
| | - A Abramovic
- Institute of Clinical and Functional Anatomy, Medical University of Innsbruck (MUI), Innsbruck, Austria; Department of Neurosurgery, Medical University of Innsbruck (MUI), Innsbruck, Austria
| | | | - J Sanudo
- Department of Anatomy and Embryology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - R S Tubbs
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA; Department of Anatomical Sciences, St. George's University, Grenada; Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - E Maranillo
- Department of Anatomy and Embryology, School of Medicine, Complutense University of Madrid, Madrid, Spain
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Danon E, Weisz B, Achiron R, Pretorius DH, Weissmann-Brenner A, Gindes L. Three-dimensional ultrasonographic depiction of fetal brain blood vessels. Prenat Diagn 2016; 36:407-17. [DOI: 10.1002/pd.4791] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 01/03/2016] [Accepted: 01/30/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Eran Danon
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
| | - Boaz Weisz
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
| | - Reuven Achiron
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
| | - Dolores H. Pretorius
- Department of Radiology; University of California, San Diego, Thornton Hospital; San Diego CA USA
| | - Alina Weissmann-Brenner
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
| | - Liat Gindes
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
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Degani S. Evaluation of fetal cerebrovascular circulation and brain development: the role of ultrasound and Doppler. Semin Perinatol 2009; 33:259-69. [PMID: 19631086 DOI: 10.1053/j.semperi.2009.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The human fetal brain is protected from pressure changes by autoregulation of the cerebral circulation. However, antenatal intrauterine cerebrovascular events are found to play an important role in the pathogenesis of perinatal brain damage. Changes in placental vascular resistance, cardiac contractibility, vessel compliance, and blood viscosity alter the normal dynamics of fetal cerebral circulation. The introduction of various sonographic techniques and the collection of data from the arterial and venous cerebral circulation provide a powerful tool for the evaluation of physiological and pathological hemodynamic events. Anatomic and physiological considerations of cerebral vasculature in healthy and disease states are relevant in studying brain development and variations in fetal brain blood perfusion. The major role of ultrasound and Doppler modalities in the evaluation of fetal cerebrovascular circulation is enabled by implementation of these considerations. Changes in flow characteristics in fetal cerebral vasculature can be used for clinical decision making in situations of fetal compromise, such as growth restriction and anemia.
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Affiliation(s)
- Shimon Degani
- Department of Obstetrics and Gynecology, Bnei Zion Medical Center, Ruth and Baruch Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
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Arnold WH, Meiselbach V. 3-D reconstruction of a human fetus with combined holoprosencephaly and cyclopia. Head Face Med 2009; 5:14. [PMID: 19563629 PMCID: PMC2709107 DOI: 10.1186/1746-160x-5-14] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 06/29/2009] [Indexed: 11/25/2022] Open
Abstract
Background The purpose of this study was to examine a human fetus with combined holoprosencephaly and cyclopia by means of histology and 3-D reconstruction to determine the internal structure and extent of the malformation. Methods The head from a human fetus at 20 weeks gestation and a diagnosis of holoprosencephaly and cyclopia was investigated histologically and three-dimensionally reconstructed with CAD techniques. The cranial bones, blood vessels, nerves, eye and brain anlagen were reconstructed. Results The 3-D reconstruction revealed both severe malformation and absence of the facial midline bones above the maxilla, and a malformation of the maxilla and sphenoid bone. The mandible, posterior cranial bones, cranial nerves and blood vessels were normal. A synophthalmic eye with two lenses was found. The prosencephalon was a single small protrusion above the diencephalon. No nasal cavity was present. Above the single eye a proboscis was found. Conclusion The absence of the facial midline bones above the maxilla and the presence of a proboscis as a nose-like structure above the cyclopic eye both mean that there was a developmental defect in the fronto-nasal facial process of this fetus.
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Affiliation(s)
- Wolfgang H Arnold
- Department of Anatomy, Faculty of Dental Medicine, University of Witten/Herdecke, Alfred Herrhausenstrasse 50, 58448 Witten, Germany.
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Vasović LP, Jovanović ID, Ugrenović SZ, Andjelković ZP. Normal subtypes of the posterior part of the cerebral arterial circle in human fetuses. ACTA ACUST UNITED AC 2008; 70:287-94; discussion 294. [DOI: 10.1016/j.surneu.2007.06.087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Accepted: 06/20/2007] [Indexed: 10/21/2022]
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Landes CA, Weichert F, Geis P, Helga F, Wagner M. Evaluation of two 3D virtual computer reconstructions for comparison of cleft lip and palate to normal fetal microanatomy. ACTA ACUST UNITED AC 2006; 288:248-62. [PMID: 16456872 DOI: 10.1002/ar.a.20289] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cleft lip and palate reconstructive surgery requires thorough knowledge of normal and pathological labial, palatal, and velopharyngeal anatomy. This study compared two software algorithms and their 3D virtual anatomical reconstruction because exact 3D micromorphological reconstruction may improve learning, reveal spatial relationships, and provide data for mathematical modeling. Transverse and frontal serial sections of the midface of 18 fetal specimens (11th to 32nd gestational week) were used for two manual segmentation approaches. The first manual segmentation approach used bitmap images and either Windows-based or Mac-based SURFdriver commercial software that allowed manual contour matching, surface generation with average slice thickness, 3D triangulation, and real-time interactive virtual 3D reconstruction viewing. The second manual segmentation approach used tagged image format and platform-independent prototypical SeViSe software developed by one of the authors (F.W.). Distended or compressed structures were dynamically transformed. Registration was automatic but allowed manual correction, such as individual section thickness, surface generation, and interactive virtual 3D real-time viewing. SURFdriver permitted intuitive segmentation, easy manual offset correction, and the reconstruction showed complex spatial relationships in real time. However, frequent software crashes and erroneous landmarks appearing "out of the blue," requiring manual correction, were tedious. Individual section thickness, defined smoothing, and unlimited structure number could not be integrated. The reconstruction remained underdimensioned and not sufficiently accurate for this study's reconstruction problem. SeViSe permitted unlimited structure number, late addition of extra sections, and quantified smoothing and individual slice thickness; however, SeViSe required more elaborate work-up compared to SURFdriver, yet detailed and exact 3D reconstructions were created.
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Affiliation(s)
- Constantin A Landes
- Maxillofacial and Facial Plastic Surgery, J.-W. Goethe University Medical Center, Frankfurt, Germany.
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Arnold WH, Kleiner A. 3D reconstruction of the cardiovascular and central nervous system of a human embryo Carnegie-stage 15--case report. Ann Anat 2004; 186:133-9. [PMID: 15125042 DOI: 10.1016/s0940-9602(04)80026-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A human embryo at Carnegie stage 15 was serially sectioned and 3D computer aided reconstructions were made to demonstrate the cardiovascular system and cranial structures and to study developmental variations at this stage. The development of the heart and pharyngeal arteries was according to the existing literature. Differences were found in the development of the arterial circle of Willis and the central nervous system. The cranial venous system seemed to show great variability. Whereas the telencephalon was not developed according to the stage, the development of the hypophysis had occurred prior to stage 15. From the results we conclude that there are remarkable individual differences in embryological differentiation of structures which have to be taken into account during staging of human embryos.
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Affiliation(s)
- W H Arnold
- Department of Anatomy, Faculty of Dental Medicine, University of Witten/Herdecke, Alfred Herrhausen Strasse 50, 58448 Witten, Germany.
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Bernard JP, Drummond CL, Zaarour P, Molho M, Ville Y. A new clue to the prenatal diagnosis of lobar holoprosencephaly: the abnormal pathway of the anterior cerebral artery crawling under the skull. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2002; 19:605-607. [PMID: 12099261 DOI: 10.1046/j.1469-0705.2002.00729.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We report a case of a 24-week-old fetus with cerebral anomalies suggestive of lobar holoprosencephaly including an unusual course of the anterior cerebral artery on Doppler examination. This abnormal trajectory of the anterior cerebral artery in holoprosencephalic brains has been described by pathologists, neurosurgeons and radiologists but our case indicates that this finding may be a useful adjunct to confirm such a difficult diagnosis prenatally.
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Affiliation(s)
- J P Bernard
- Department of Obstetrics and Gynecology, CHI Poissy/St. Germain, France
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Arnold WH, Lang M, Sperber GH. 3D-reconstruction of craniofacial structures of a human anencephalic fetus. Case report. Ann Anat 2001; 183:67-71. [PMID: 11206985 DOI: 10.1016/s0940-9602(01)80015-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
It was the purpose of this study to investigate the craniofacial bones, cartilages and major blood vessels of a human anencephalic fetus and to describe the malformations of these structures accompanying this developmental disruption. The head of a 16 week old human fetus with anencephaly was serially sectioned and the craniofacial bones, cartilages and major blood vessels were traced and reconstructed by 3D-computer technology. The sphenoidal, temporal and occipital bones showed severe malformations, whereas the bones of the facial cranium were normally developed. Both internal carotid arteries ended within the cerebro-vascular area with no further branches. The vertebral arteries also ended within the cerebro-vascular area. No arterial circle of Willis was developed. The notochord terminated normally in the sphenoid body. The observations indicate that the possible reason for this malformation was non-closure of the anterior neuropore of the neural tube. The normal termination of the notochord suggests that it had no influence on the pathogenesis of this malformation. The malformations of the temporal and occipital bones are contradictory to the hypothesis of Marin-Padilla (1991) that anencephaly is caused by a maldevelopment of the sphenoidal bone.
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Affiliation(s)
- W H Arnold
- Department of Anatomy, Faculty of Dental Medicine, University of Witten/Herdecke, Germany.
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Arnold WH, Sperber GH, Machin GA. Cranio-facial skeletal development in three human synophthalmic holoprosencephalic fetuses. Ann Anat 1998; 180:45-53. [PMID: 9488905 DOI: 10.1016/s0940-9602(98)80131-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In three human fetuses with synophthalmic holoprosencephaly (8, 14, 23 wks. p.c.) and two normal human fetuses (9 and 13 wks. p.c.) the anatomy of the cranial base, facial cranium and their relation to the notochord was studied using serial histological sections and computer aided three-dimensional reconstruction methods. Mesethmoidal cartilage differentiation was variably deficient in all three holoprosencephalic cases. The premaxillary bones were rudimentary with missing tooth buds. The development of the sphenoid bone was defective in two of the holoprosencephalic cases (8, 14 wks. p.c.). The notochord terminated normally within the sphenoid body in all investigated cases. Our results indicate that in holoprosencephaly there is a general defect in the midline cranial cartilage differentiation rostral to the notochord.
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Affiliation(s)
- W H Arnold
- Department of Anatomy II, Faculty of Dentistry, University of Witten/Herdecke, Germany
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Abstract
BACKGROUND Computer-based, three-dimensional reconstruction of histological sections is necessary for solving a diversity of questions in morphology and anatomy. Programming software for this purpose is difficult and time-consuming. Therefore, we tested if commercially available product-design software is useful for reconstructing anatomical virtual models. METHODS We used Alias Wavefront Studio software on a Silicon Graphics workstation. Sections were projected with a newly developed microslide projector on a digitizing board and digitized interactively. Alternatively, pictures of sections were digitized on screen. The resulting set of contours was used as scaffold around which a surface was created manually. RESULTS Repeated creation of the same object and subsequent measurements gave results that will be sufficiently reliable for many purposes. The visual presentation of objects satisfy highest demands. Little time is needed to reconstruct simple objects, and the time used for complex virtual models is acceptable. Manipulation of objects on screen is nearly in real time and rendering speed is high. CONCLUSIONS Product-design software packages are a readily available and useful option for anatomists who want to do virtual reconstructions quickly without programming software themselves.
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Affiliation(s)
- A Haas
- Institut für Spezielle Zoologie und Evolutionsbiologie mit Phyletischem Museum, Friedrich-Schiller-Universität Jena, Germany
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