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Introduction: Three-dimensional measurements of intracranial volume (ICV) can guide clinical management of brain and skull disorders. However, widespread clinical access is limited by the scarcity of software methods for analyzing CT scans, which are more available than MRI images, and the inaccessibility of proprietary and expensive commercial software. The presented method can calculate ICV from CT scans, using an open-source software, 3D Slicer. Methods: The open-source workflow was optimized with a data-driven approach to find the optimal parameters for ICV accuracy. The accuracy of the open-source method was determined by comparing it to commercial and proprietary software with CT scans of pediatric hydrocephalic macrocephaly patients with craniosynostosis undergoing total vault reconstruction (N = 5 patients,15 scans). Results: An open-source pipeline that combines an initial semi-automatic segmentation of a coronal CT reconstruction with a fully automatic segmentation minimizes the ICV error. The open-source method shows excellent agreement with both the commercial and proprietary software methods (R2 = 0.998 and 95% confidence interval of best-fit line slope: [0.986; 1.047], [0.985;1.066] respectively). The mean percent difference of ICV measurements of the open-source software from the commercial software was −0.56% [95% CI: −1.08%, −0.028%] and from the proprietary software was −0.07% [95% CI: −1.26%, 1.1%]. The mean percent difference of ICV measurements of the commercial software from the proprietary software was 0.36% [95% Confidence Interval: −0.61%, 1.32%]. Conclusions: This is the first study comparing an open-source method for measuring ICV with commercial and proprietary options. A high degree of fidelity was found, confirming this open-source method as a viable option for clinicians who are looking to incorporate ICV measurements into their practice. [ABSTRACT FROM AUTHOR]

A 15-year-old male presented at a neurosurgeon's office following a traffic accident. A CT scan revealed bone deficiency in the temporoparietal area. The surgical solution involved implanting a 3D-printed prosthesis into the skull. Axial 3D created the model using stereolithography 3D printing technology with Poly Methyl Methacrylate (PMMA). The use of 3D printing as a surgical aid is gaining popularity. Our experience with the presurgical model demonstrates its utility in individualized surgical planning for skull defects. [ABSTRACT FROM AUTHOR]

Background: Childbirth is a physiological process with significant medical risk, given that neurological impairment due to the birthing process can occur at any time. Improvements in risk assessment and anticipatory interventions are constantly needed; however, the birthing process is difficult to assess using simple imaging technology because the maternal bony pelvis and fetal skeleton interfere with visualizing the soft tissues. Magnetic resonance imaging (MRI) is a noninvasive technique with no ionizing radiation that can monitor the biomechanics of the birthing process. However, the effective use of this modality requires teamwork and the implementation of the appropriate safeguards to achieve appropriate safety levels. Objective: This study describes a clinically effective and safe method to perform real-time MRI during the birthing process. We reported the experience of our team as part of the IMAGINAITRE study protocol (France), which aimed to better understand the biomechanics of childbirth. Methods: A total of 27 pregnant women were examined with 3D MRI sequences before going into labor using a 1-Tesla open-field MRI. Of these 27 patients, 7 (26%) subsequently had another set of 3D MRI sequences during the second stage of labor. Volumes of 2D images were transformed into finite element 3D reconstructions. Polygonal meshes for each part of the fetal body were used to study fetal head moldability and brain compression. Results: All 7 observed babies showed a sugarloaf skull deformity and brain compression at the middle strait. The fetus showing the greatest degree of molding and brain shape deformation weighed 4525 g and was born spontaneously but also presented with a low Apgar score. In this case, observable brain shape deformation demonstrated that brain compression had occurred, and it was not necessarily well tolerated by the fetus. Depending on fetal head moldability, these observations suggest that cephalopelvic disproportion can result in either obstructed labor or major fetal head molding with brain compression. Conclusions: This study suggests the presence of skull moldability as a confounding factor explaining why MRI, even with the best precision to measure radiological landmarks, fails to accurately predict the modality of childbirth. This introduces the fetal head compliance criterion as a way to better understand cephalopelvic disproportion mechanisms in obstetrics. MRI might be the best imaging technology by which to explore all combined aspects of cephalopelvic disproportion and achieve a better understanding of the underlying mechanisms of fetal head molding and moldability. [ABSTRACT FROM AUTHOR]

During a provenience research project funded by the German Lost Art Foundation, an anthropological and paleopathological investigation of 33 human skulls from the natural historical collection of the Gotha Castle Foundation in Central Germany was performed. The skulls originate from the former colony of the Dutch East Indies, nowadays Indonesia, and were incorporated into the collection between 1862 and 1880. Written sources including remarks and labels on the skulls indicate that the majority originates from military or prison hospitals in Batavia. Others were those of local men who took part in a war against the colonial government and were reportedly executed. Military, as well as medical officers, brought the skulls to Europe. Anthropological and paleopathological investigation was carried out by non-invasive, morphological methods, including reflected-light microscopy, and endoscopy. Most skulls originate from young adult males, only one from a female. In five individuals, possible traces of scurvy were detected. These include new bone formations in and around the alveoli, in areas of muscle attachment marks, and in other typical locations, such as the external surface of the greater wings of the sphenoid. From the current paleopathological record, such traces are mainly known from infants. In six individuals, possible traces of anemic marrow expansion were observed. In further six individuals, granular impressions, as well as distinct digital impressions were detected, representing features often associated with tuberculous meningitis. Against the background of the documented historical context, these findings probably indicate persistent malnutrition and harsh living conditions of the individuals. [ABSTRACT FROM AUTHOR]