Biomedical subjects

W Jerry Oakes

Publications and source records attributed to W Jerry Oakes.

At least 37 records · Page 2Linked to original sources

PubMed2006

Chiari I malformation, caudal regression syndrome, and Pierre Robin Syndrome: a previously unreported combination.

CASE: The authors report a child born with a constellation of findings including Chiari I malformation, Pierre Robin syndrome, and caudal regression syndrome. In addition, this child was found to have a fatty-infiltrated filum terminale and a low conus medullaris. DISCUSSION AND CONCLUSION: In isolation, the Chiari I malformation has been reported in patients with caudal regression and Pierre Robin syndrome. Speculation has been given to the possibility of a common insult to early mesodermal development and each of these pathological entities. To our knowledge, this is the first report of a single patient that possessed all three entities (i.e., Chiari I malformation, Pierre Robin syndrome, and caudal regression syndrome). Further case reports as this may shed light on the dysembryology that results in each of these diagnoses.

Arnold-Chiari Malformation↗

PubMed2006

An unusual sequelae of an infected persistent dermal sinus tract.

CASE REPORT: We present a case of a child born with a birthmark over the lumbar spine, which harbored a pinhole-sized opening. At 6 months of age the child presented with fever of unknown origin. Subsequent lower extremity pain resulted in imaging studies that revealed a spinal mass with extension into the posterior mediastinum. At operation, the child was found to have an infected dermal sinus tract. DISCUSSION: This case highlights the importance of a thorough examination of the midline craniospinal axis in children with fever of unknown origin. To our knowledge, this is the first reported case of an infected dermal sinus tract with extension into the posterior mediastinum.

Bacteroides Infections↗

PubMed2006

History of surgery for cerebrovascular disease in children. Part II. Vein of Galen malformations.

Vein of Galen aneurysmal malformations are a mixed group of lesions characterized by an abnormal fistula between abnormal distal branches of the choroidal and/or posterior cerebral arteries and the great vein of Galen. In this paper the authors trace the historical evolution of the current approach to diagnosis and treatment, and the literature is reviewed comprehensively. During the historical era, vein of Galen malformations were described in individual case reports and an early classification system was developed. In the early era of treatment, open surgery was the preferred approach, although morbidity and mortality rates were high. The development of neurointerventional techniques allowed the introduction of occlusive materials into the fistula, with pronounced improvements in clinical outcome.

Cerebral Veins↗

PubMed2006

History of surgery for cerebrovascular disease in children. Part III. Arteriovenous malformations.

Arteriovenous malformations (AVMs) are the most common cause of intracerebral hemorrhage in children. In this paper the authors trace the historical evolution of the recognition, diagnosis, and treatment of pediatric intracerebral AVMs, and they summarize the contemporary approach and current controversies surrounding treatment of these lesions. Important distinctions between adult and pediatric AVMs are emphasized.

Child↗

PubMed2006

History of surgery for cerebrovascular disease in children. Part I. Intracranial arterial aneurysms.

Intracranial aneurysms are rare in children, and their origins and treatment methods tend to be different from those in these same entities in adults. These lesions tend to be congenital or to have an infectious or traumatic origin. In the current paper the authors trace the historical evolution of the diagnosis and treatment of intracranial aneurysms in children. Based on the literature, these lesions appear to occur in children in less than 3% of all series. The literature also supports the suggestion that symptoms from these aneurysms are often from mass effect and that giant aneurysms and lesions in the posterior cranial fossa are relatively more common in children than in adults. The termination of the carotid artery and the anterior cerebral artery seem to be disproportionately common sites of aneurysm formation in this cohort. Interestingly, surgical outcomes in children appear to be moderately better than in adults. Based on the literature, the claim can be made that a multidisciplinary approach to the management of such aneurysms can yield good outcomes in a very high percentage of children treated.

Cerebrovascular Disorders↗

PubMed2006

Lipomyelomeningocele and arteriovenous malformation: case reports and a review of the literature.

INTRODUCTION: The caudal end of the human embryo is a major site of multipotential cells. We now present two cases of simultaneous arteriovenous malformation and lipomyelomeningocele and review the literature regarding this potential association. DISCUSSION: In the context of rarity and following a review of the literature, both an arteriovenous malformation and lipomyelomeningocele in the same patient appears to be more than serendipitous. The natural history of these vascular malformations in patients with concomitant lipoma or lipomyelomeningocele cannot be determined from such a small group. However, only one patient in our review was found to have consequences thought to be related to their arteriovenous malformation, which was in the upper thoracic region and not related to a lipomyelomeningocele.

Arteriovenous Malformations↗

PubMed2006

Scoliosis in a child with Chiari I malformation and the absence of syringomyelia: case report and a review of the literature.

BACKGROUND: Scoliosis is a common finding in children with Chiari I malformation and syringomyelia. The development of scoliosis associated with a Chiari malformation typically has been ascribed to the presence of syringomyelia. Decompression of the hindbrain hernia will often alleviate the syringomyelia and, in many cases, stabilize or reverse the scoliosis. CASE REPORT: We report a child with Chiari I malformation and scoliosis who presented with Valsalva-induced headache/neck pain. MRI revealed no syringomyelia or hydrocephalus. Radiographs revealed that her scoliotic curvature was approximately 13 degrees and was a single levoscoliotic curve. This patient underwent a posterior fossa decompression with duraplasty for her Valsalva-induced pain. Postoperatively, she had resolution of her pain and there has been no progression of her scoliosis at 3 years follow-up. PROGNOSIS: Intriguingly, and scattered throughout the medical literature, many have noted cases of scoliosis in patients with only a Chiari I malformation and no syringomyelia. Moreover, experimental studies have induced scoliosis in animals after compression of the dorsal columns. After a review of the medical literature regarding a potential cause and effect of herniated hindbrain-induced scoliosis in the absence of syringomyelia, this association although rare, does seem plausible.

Adolescent↗

PubMed2006

A simple method to deter retethering in patients with spinal dysraphism.

OPERATIVE TECHNIQUE: The authors describe a technique that may be of benefit to patients with spinal dysraphism and a tethered spinal cord. Twenty pediatric patients (ten initial operations and ten reoperations) after the detethering of their spinal cord had intradural retention sutures placed with subsequent duraplasty using autologous thoracolumbar fascia. RESULTS: To date, no patient has had signs or symptoms or recurrence of signs or symptoms of a tethered spinal cord. No complications have resulted from this maneuver. The mean follow-up time for this cohort was 8 years. The advantages of this intervention include maintaining a relatively normal position of the spinal cord within the thecal sac, thus decreasing the potential adherence of the dorsally scarred aspect of the dysmorphic cord to an overlying graft whether synthetic or native.

Follow-Up Studies↗

PubMed2006

Unilateral occipital hyperhidrosis following Chiari I decompression: case report and a review of the literature.

INTRODUCTION: Paroxysmal unilateral cephalic hyperhidrosis is a rare disorder of the autonomic nervous system. CASE REPORT: We report an adult male who developed this disorder almost 20 years after posterior fossa decompression for Chiari I malformation with syringomyelia as a child. Further, the patient presented with spastic diplegia. To date, this patient has refused further operative intervention. The medical literature is reviewed regarding this unusual phenomenon. CONCLUSION: To our knowledge, hyperhidrosis of the occiput has not been previously reported in a patient with Chiari I malformation with an associated syringomyelia.

Adult↗

PubMed2006

The tabatière anatomique.

There is scant detailed information regarding the tabatière anatomique (anatomical snuff box) in the literature. The authors dissected this area in 15 adult cadavers (30 sides) and made measurements and observations of this region. We found that the average mean width and length of this geometric area was 4 cm and 6 cm, respectively. Although the dimensions of the tabatière anatomique tended to be larger among male specimens this trend did not reach statistical significance (P > 0.05). There was no statistical difference between left and right sides. The majority (70%) of specimens was noted to have connections between the cephalic vein and the vena comitantes of the radial artery within the tabatière anatomique. Five specimens were noted to have a muscular branch to the abductor pollicis brevis muscle arising from the dorsalis pollicis artery in the tabatière anatomique. The dorsalis pollicis artery was found to originate in the tabatière anatomique in all specimens. One right-sided specimen was noted to have an intraosseous branch of the radial artery that entered the styloid process of the radius. A well-formed collection of fat was noted between the styloid process and base of the first metacarpal in all specimens. This fat pad completely covered the radial artery in the majority of specimens and had loose connections to both the first and second dorsal compartments. The branches of the superficial branch of the radial nerve always originated distal to the tendon of the EPB muscle. These data may prove useful to the surgeon or clinician who operates or examines this interesting anatomical area.

Aged↗

PubMed2006

Complete ossification of the human falx cerebri.

During the routine dissection of the head and neck of an adult male cadaver complete ossification of the falx cerebri was noted. Anomalous ossification was not found in any other dural component or other parts of the body. The brain appeared grossly normal. Histological sections showed normal ossification processes involving the falx cerebri. In addition, rare scattered deposits of metastatic poorly differentiated carcinoma within the trabecular spaces were seen. Reports of isolated islands of ossification involving primarily the most anterior part of the falx cerebri in man are found in the literature. Our case report represents to our knowledge, the first report of complete ossification of this dural partition. Whether this is simply an anomalous configuration or due to the few metastatic cells found within this region remains unclear.

Aged↗

PubMed2006

Bony anomaly of Meckel's cave.

This study describes the seemingly rare occurrence of bone formation within the proximal superior aspect of Meckel's cave thus forming a bony foramen for the proximal trigeminal nerve to traverse. The anatomy of Meckel's cave is reviewed and the clinical potential for nerve compression from this bony anomaly discussed.

Adult↗

PubMed2006

Descriptive anatomy of the insertion of the biceps femoris muscle.

The biceps femoris is the most lateral component of the so-called hamstring muscles. Classically, this muscle's insertion into the head of the fibula has been described but further details of its anatomy have not been universally appreciated. Additional insertions into the crural fascia and tibia have been described. We dissected 56 cadavers paying especially close attention to the insertion of the biceps femoris muscle. The tendon of this muscle was found to have both medial and lateral slips each with an anterior and posterior component. Further, we found an attachment not only into the lateral condyle of the femur but also the popliteus tendon and arcuate popliteal ligament. Our study has found that the tendon of insertion of the biceps femoris muscle is more complex than described previously and suggests that this tendon may be far more important in knee stability based on the multiple attachment sites found. We hypothesize that there may be a synergistic effect between the biceps femoris and the popliteus muscles based on our findings of an additional attachment of the biceps femoris tendon into the popliteus tendon. This study provides new detailed nomenclature for the description of the tendon of insertion of the biceps femoris muscle and indicates that the current description of the insertion of the tendon of the biceps femoris muscle should be revised. The clinician must have a thorough understanding of this anatomy before correct therapeutic maneuvers can be implemented.

Humans↗

PubMed2006

An unusual case of a mediastinal mass in a cadaver.

Since 1975, only approximately 60 saphenous vein graft aneurysms have been reported in the medical literature. We now report this unusual finding in a male cadaver who had undergone a recent coronary artery bypass grafting procedure. Although aneurysm formation is an unusual complication of saphenous vein graft surgery, the diagnosis must be suspected particularly in the face of a mediastinal mass on chest radiography in patients who have undergone coronary artery bypass grafting. Needle biopsy in these cases may prove lethal. We believe this to be the first description of this complication in a cadaver.

Aged↗

PubMed2006

Artificial deformation of the human skull: a review.

Early examples of intentional human cranial deformation predate written history. Intentional cranial deformation as an extreme has seemingly not persisted into this century. However, mild forms of this manipulation are still practiced by various groups worldwide. Accidental cranial deformation or mild forms of intentional cranial deformation may be encountered by the clinician or anatomist. We review the literature regarding intentional manipulation of the human cranium.

History, 19th Century↗

PubMed2006

Neurenteric cyst: case report and a review of the potential dysembryology.

We report a 13-year-old female who presented to an outside emergency room following blunt trauma to the head. As part of her evaluation, an unenhanced CT of the face and radiographs of the cervical spine were performed. She was referred to our clinic with "abnormal" imaging. Radiographs revealed dysmorphic cervical spine and ventral clefting of the vertebral bodies from C7-T2. A subsequent MRI was obtained that demonstrated a large spinal cord mass. MRI demonstrated an unenhanced intramedullary mass of the cervicothoracic spinal cord measuring approximately 1.5 cm in greatest axial diameter. Surgical exploration of her intraspinal mass revealed a neurenteric cyst. Spinal neurenteric cysts are categorized in the spectra of occult spinal dysraphism and most likely arise from incomplete separation of the developing notochord and foregut in the embryo. We discuss potential etiologies for the formation of such cysts. The clinician should consider neurenteric cysts in their differential diagnosis of patients with spinal dysraphism and/or intraspinal masses.

Adolescent↗

PubMed2006

Dissection of a rare accessory muscle of the leg: the tensor fasciae suralis muscle.

We report a case of the rare tensor fascia suralis muscle. This muscle was found during the routine dissection of the lower extremity in an adult male cadaver. No other anomalies were noted in this specimen. The innervation of this muscle was via the tibial component of the sciatic nerve. Although seemingly rare, the tensor fascia suralis muscle may be considered by the clinician in the differential diagnosis of masses over the posterior lower extremity.

Adult↗

PubMed2006

Anomaly of the supraclavicular nerve: case report and review of the literature.

We report a male cadaver found to have his right intermediate branch of the supraclavicular nerve piercing the clavicle. No other anomalies were found in this specimen. Following a review of the literature, it appears that symptoms related to this finding are rare but do occur most commonly involving the intermediate branch of the supraclavicular nerve. Symptoms may be alleviated with surgical decompression of the entrapped nerve. Although rare, the clinician should include entrapment of the supraclavicular nerve within the clavicle in their differential diagnosis of shoulder pain.

Aged, 80 and over↗