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Introduction: Depressive symptoms are most common non-motor symptoms in Parkinson's disease (PD), which is often overlooked due to absence of rapid and objective diagnostic biomarkers. Electroencephalography (EEG)-based event-related potentials (ERPs) is commonly used to assess emotional processes. The aim of this study was to investigate changes in ERPs in PD patients exhibiting depressive symptoms and to provide a reliable biomarker for assisting in the diagnosis of PD with depressive symptoms. Methods: We conducted a case–control study involving 30 PD patients with (dPD group) or without depressive symptoms (nPD group) and 13 age matched healthy controls (HC). We recorded EEG of the patients during the emotional picture stimulation task and analyzed the difference in the early ERPs potentials (P1, N170, early posterior negativity) and their correlation with the severity of symptoms in PD patients. Results: Our results found that P1 amplitude in the occipital region of the dPD group in response to emotional faces was significantly higher than that of nPD and HC group, and it was positively correlated with severity of depressive symptoms in PD patients. Conclusion: Our study shows that facial expression-induced enhancement of P1 amplitude can be utilized as a rapid and objective indicator to screen for depressive symptoms in PD. [ABSTRACT FROM AUTHOR]

Cranial vault thickness (CVT) and its variations provide valuable insights into an individual's biological attributes such as age and sex. This paper aimed to assess the correlations of CVT with age and sex and develop a regression model for age estimation in Malaysian subadults using computed tomography (CT) images. A total of 521 CT images (male/female: 279/242; age range: 0–20 years; Malay/Chinese/Indian: 221/145/155) were included in the study. Correlations of CVT measurements with age and sex, including frontal bone thickness (FBT), occipital bone thickness (OBT), left parietal bone thickness (LPBT), and right parietal bone thickness (RPBT) were assessed and regression formulae were developed for age estimation in subadults. A significant correlation between CVT measurements and age was demonstrated (p < 0.001). Age estimation was most accurate in the younger age group (< 2 years) at frontal and occipital, and accuracy decreases in the older age groups. Additionally, sexual dimorphism was evident in the frontal and parietal bone thickness within the age range of 3–6 years and 16–20 years, respectively. In conclusion, the findings suggested CVT measurements could be used to corroborate other age estimation methods for subadults. [ABSTRACT FROM AUTHOR]

Purpose: To describe a case of an anomalous posterosuperior course of the V3 segment of the right vertebral artery (VA) that penetrated the occipital bone (wall of the jugular foramen). Methods: A 33-year-old healthy woman underwent cranial magnetic resonance (MR) imaging and MR angiography from the upper cervical to the intracranial region using a 3-Tesla scanner to screen for asymptomatic brain lesions, including cerebrovascular diseases. Results: MR angiography showed no pathological arterial lesions such as aneurysms; however, there was an anomalous posterosuperior course of the V3 segment of the right VA. On MR angiographic source images and coronal reformatted images, the right VA was observed to penetrate the occipital bone lateral to the right hypoglossal canal and is located on the inferoposteromedial wall of the right jugular foramen and enter the posterior fossa at a higher level than the foramen magnum. Conclusion: We present a case in which the right VA showed an anomalous posterosuperior course at the craniovertebral junction. It is extremely rare for a VA to take a higher course. To our knowledge, this is the first report of such a VA variation in the relevant English-language literature. We speculated that the right VA of our patient was formed by the persistence of one more cephalad primitive artery than the first intersegmental artery, not by the persistence of the primitive hypoglossal artery. Careful observation of MR angiographic source is useful and important for identifying the VA penetrating the occipital bone. [ABSTRACT FROM AUTHOR]

Background: Fractures of the paracondylar process of the occipital bone may cause headshaking, neck pain and neurologic deficits. The condition is being recognised more frequently with increasing availability of computed tomography. However, to date only limited information is available as to presentation, treatment, surgical approach and outcome. Objectives: To describe the clinical signs, imaging findings, treatment, surgical approach and outcome in three horses diagnosed with paracondylar process fracture. Study design: Retrospective case series. Methods: Clinical records and diagnostic images of affected cases were reviewed. Results: Two cases had ventral nonunion fractures—one of these presented with neck pain, headshaking and behavioural changes, while in the other the fracture was a suspected incidental finding in a case of poor performance. A third case with a more dorsal fracture presented with acute facial nerve paralysis. Diagnosis was by computed tomography in all cases, although imaging of ventral fractures by radiography was found to be feasible. Where clinical signs could be associated confidently with the fracture, conservative management resulted in improvement but not complete resolution. Repeated recurrence of clinical signs after prolonged periods of remission necessitated surgical removal in one case, which was readily accomplished with the aid of ultrasound guidance, and led to rapid resolution of clinical signs without significant post‐operative complications. The surgical approach is described. Main limitations: Limited follow‐up was available. Conclusions: Paracondylar process fracture should be considered as a differential diagnosis for headshaking, neck pain, poor performance and facial paresis, and is a justification for performing computed tomography in such cases. A multi‐disciplinary approach is beneficial due to the potential for orthopaedic, neurologic, ophthalmologic and behavioural clinical signs, with additional need for expertise in diagnostic imaging and pain management. Surgical fragment removal should be considered for ventral fractures. [ABSTRACT FROM AUTHOR]

Craniomandibular osteopathy (CMO) is a proliferative, self-limiting, nonneoplastic disease of growing dogs characterised by excessive new bone formation on the skull and mandible. The radiographic findings of CMO are well described; however, limited reports of the computed tomographic (CT) appearance are available. This paper aims to characterise the spectrum of CT findings that can occur with CMO. The study is retrospective, descriptive, multicenter, and includes 20 cases. Age at presentation ranged from 6 weeks to 12 months, with no sex predisposition. Scottish terriers were overrepresented (65%); other breeds included Cairn terrier, Jack Russell terrier, Staffordshire bull terrier, labrador retriever, golden retriever, akita and Slovakian rough-haired pointer (one of each breed). Terrier breeds represented 80% (16/20) of the patient cohort. Mandibular osteoproliferation was present in all patients (marked in 80%, bilateral in 95%), affecting the rostral mandible in 25%, body in 85%, and ramus in 80%. Tympanic bulla osteoproliferation was present in 60% (12/20) of patients (all marked, bilateral in 75%). Cranial osteoproliferation (frontal, parietal, temporal, occipital bones or maxilla, or combinations of them) was present in 90% (18/20) of patients (40% marked, 27% moderate, 33% mild). Nasopharyngeal narrowing was seen in all 12 patients with tympanic bulla osteoproliferation (67% marked, 27% moderate) and caused nearly complete occlusion in two of them. External ear canal stenosis was seen in 55% (11/20) of patients (63% marked, 37% moderate, all bilateral). Temporomandibular joint (TMJ) impingement was suspected in 83% (10/12) of patients with marked tympanic bulla osteoproliferation (75% bilateral). Osteolysis with a moth-eaten pattern was seen in the mandible of 10/20 dogs, the calvarium of 5/20 dogs, and the maxilla of 1/20 dogs (5%). Lymphadenomegaly (mandibular and medial retropharyngeal) was found in 15/20 patients (70% mild, 30% moderate). The most severe CT changes were seen in Scottish terriers. CT allows for detailed characterisation of the bony changes associated with CMO, including the effects occurring secondary to osteoproliferation surrounding the tympanic bullae such as TMJ impingement, external ear canal stenosis, and nasopharyngeal narrowing. Osteoproliferation affecting the cranium and the presence of osteolysis were seen more frequently in this study than previously reported in CMO. [ABSTRACT FROM AUTHOR]

In the present study, the most commonly observed types of occipital condyles were oval, followed by circular and two-portioned shapes. Occipital condyles are small bilateral extensions of the occipital bone that hold crucial implications for neurosurgical practice due to their association with various disease processes affecting the craniovertebral junction. A comprehensive understanding of the bony anatomy and variations in occipital condyles is imperative for optimising neurosurgical approaches. The primary objective of this study is to conduct an in-depth investigation of occipital condyles. We examined 40 dry human skulls, meticulously measuring various parameters such as length, breadth, anterior, and posterior intercondylar distances. The shapes of occipital condyles were classified into distinct types: oval, circular, eight-shaped, kidney-shaped, deformed, two-portioned, oval convex, and pyramid. The documented parameters of occipital condyles and their variations are poised to serve as invaluable guidelines for future surgeons. Possessing a thorough understanding of occipital condyle morphometry can significantly facilitate the instrumentation process, mitigating the risk of neurovascular damage. We firmly believe that the outcomes of our research will establish a comprehensive reference database, aiding in the development of implants and the formulation of optimal surgical approaches tailored to the intricacies of occipital condyles. [ABSTRACT FROM AUTHOR]

The upper cervical spine is responsible for a significant portion of the flexion, extension and rotation movements of the whole cervical spine. It is a complex region with anatomical and biomechanical relationships between the occipital condyles, atlas, axis and their joints. These make this a region of special interest in the context of trauma. In this article we review the anatomy of the cranio-vertebral junction, the clinical patterns of injury, and the options in their clinical management. [ABSTRACT FROM AUTHOR]

Background: European hedgehogs (Erinaceus europaeus) are small insectivorous mammals common in Europe. With increased urbanization, the species become more frequent in the cities and near other human dwellings. The anatomy of the species with the use of diagnostic imaging techniques along with the classical anatomical methodology has not been researched before. In addition to the description of this species' skull, the data may contribute to progress in hedgehog medicine, delivering a basis for diagnosing and treating head trauma in this species. Results: Cadavers of 30 European hedgehogs have been used to study the anatomy of the head of the species. Along with classical anatomical techniques – latex and corrosion cast specimens, x-ray, and cone-bean computed tomography scans were performed. The methods were then compared, and the detailed anatomy of the head was described. The skull of the Western European hedgehog was elongated and oval in shape, and could be divided into two distinct regions: one formed of neurocranial bones and the other of facial bones. The neurocranium was composed of the following bones: the occipital, interparietal, parietal, frontal, temporal, sphenoid, ethmoid, and pterygoid bones. The following facial bones were identified: the incisive, nasal, maxilla, zygomatic, palatine, vomer, and the mandible. The most important findings include the primitive tympanic bullae, the absence of a supraorbital foramen, and the lacrimal bones, which were indistinguishably fused with the maxillae. Conclusions: The results of the study may be used in future research on the comparative anatomy of the other members of the Eulipotyphla order. With the increase of hedgehogs in the cities, it is important to establish new diagnostic and treatment protocols for wildlife rehabilitation centers. Anatomical and radiological descriptions may be used as a base for such work. The anatomical features of the hedgehog skull described in the study may prove useful for further studies from a comparative anatomical perspective. Additionally, the data may serve as a basis for developing identification guidelines for archaeological studies and forensic research. [ABSTRACT FROM AUTHOR]

Objective: To report a digital workflow for use and long-term outcome of cranioplasty with a 3D-printed patient-specific Polyetheretherketone (PEEK) implant in a 12-y-old German Shepherd dog after surgical removal of an extensive occipital bone multilobular osteochondrosarcoma (MLO). Study design: Retrospective case report. Animal: A 12-year-old neutered Female German Shepherd dog was presented with facial deformity, blindness, tetraparesis, and ataxia. Magnetic resonance imaging (MRI) and computed tomography (CT) identified a large skull-based mass extending extra-and intracranially with severe compression of the cerebellum and occipital lobes of the cerebrum. Methods: One-stage decompressive craniectomy using virtual surgical planned 3D-printed craniotomy cutting guides and the Misonix BoneScalpel® and reconstruction with a patient-specific 3D-printed PEEK cranial implant. Results: 3D-printed craniectomy cutting guides allowed an adequate fit of the cranial implant to the original skull. Misonix BoneScalpel® allowed performing a safe and extensive craniectomy. Postoperative CT (8  weeks after surgery) confirmed the PEEK cranial implant to be in place and without implant rejection. Clinically, the neurological examination identified only a right-hind limb delay in proprioception 8  weeks postoperatively, which remained unchanged at 18  months after surgery. Adjunctive treatment included metronomic chemotherapy. Eighteen months after surgery the dog passed away for reasons unrelated to the MLO, no implant-related complications were reported. Conclusion: 3D-printed craniectomy cutting guides, patient-specific PEEK cranial implant, and metronomic chemotherapy can lead to a successful longterm outcome in dogs with extensive skull MLO. Clinical significance: PEEK is an alternative biomaterial that can be used successfully for skull reconstruction. [ABSTRACT FROM AUTHOR]

Objective: An intraosseous arteriovenous fistula (AVF) is a rare fistula with an intracranial shunted pouch. A case of an intraosseous AVF at the squamous part of the occipital bone with spontaneous occlusion of diploic venous drainage is described. Case Presentation: The patient, a Japanese woman in her 80s, presented with headaches at the back of the head and a history of multiple unruptured cerebral aneurysms but no recent head trauma. MRA showed abnormal signals in the occipital diploic region, and DSA showed an intraosseous AVF with a shunted pouch in the squamous part of the occipital bone near the inion. This was not seen on MRA 6 months earlier. One month later, follow-up examinations showed spontaneous occlusion of the diploic venous drainage, leading to a change in retrograde drainage into the superior sagittal sinus. Transvenous coil embolization was performed, and the shunted pouch was completely occluded. Postoperatively, the patient's symptoms resolved, and subsequent follow-ups showed no recurrence of the AVF. Conclusion: This case suggested that the vascular architecture of intraosseous AVFs might change over a short period. Transvenous embolization was effective in obliterating the intraosseous shunted pouch. [ABSTRACT FROM AUTHOR]

Since the facial bone remains are mostly damaged or fractured in the crime scenes, the occipital bone (OB) is a possible skull bone to be used for sex determination in forensic sciences. The high accuracy of the use of the OB for sex estimation has been reported in many populations. This recent study attempted to modify and apply the 12 parameters on OB for such determination in the Northeastern Thai skulls. Discriminant function analyses and descriptive statistics were performed. The results showed that all parameters including the hormion-basion length, bi-lower part of temporo-occipital suture breadth, bi-asterios breadth, opisthion-lambda length, foramen magnum breadth, foramen magnum length, right-lower part of temporo-occipital suture to opisthion length, left-lower part of temporo-occipital suture to opisthion length, right-asterion to basion length, left-asterion to basion length, right-asterion to lambda length, and left-asterion to lambda length of males were significantly higher than those of females (P<0.01). Interestingly the discriminant equation analyzed from univariable showed that the temporo-occipital suture breadth (TOB) has the highest accuracy rate (75.4 %) among 12 parameters. For multivariable analysis via stepwise method, the hormion-basion length (HBL), temporo-occipital suture breadth (TOB), and left asterion to basion length (Lt. ABL) provided the highest rate of accuracy (78.8 %). In conclusion, this study suggested that TOB, HBL, and Lt. ABL are potential parameters to be used for sex determination on dry occipital bone remains of the Northeastern Thai population. [ABSTRACT FROM AUTHOR]

Osteosarcomas predominantly manifest in the long bones of the extremities, with rare occurrences in the skull. A case involving of a 53-year-old female who presented to the authors' hospital for examination due to dizziness was incidentally found to have an occipital bone mass, which was initially diagnosed as a benign tumor and did not receive sufficient attention. Two years later, owing to tumor enlargement, the patient underwent further evaluation at the same institution, which revealed evidence of occipital bone destruction. Pathological analysis confirmed the diagnosis of osteosarcoma. The patient underwent surgical resection followed by radiotherapy. Despite its infrequency and uncharacteristic initial presentation, skull osteosarcomas should not be overlooked. [ABSTRACT FROM AUTHOR]

Contrecoup brain injury refers to the classical opposite of the primary impact. Tamil Nadu has the highest rate of road traffic accident in India. Madurai has peak mortality due to accidents in India. Previous studies done on contrecoup head injury had shown patterns of injuries and mechanism of injury. Outcome and management of only occipitofrontal contrecoup head injury has been taken in this study. Mortality in this specific group is very high. Seventy-six patients of this specific head injury were admitted at Government Rajaji Hospital, Madurai. Patients were assessed for Glasgow coma scale (GCS), age, sex, progression of volume, mortality, traumatic brain injury-induced coagulopathy, and pillion rider outcome. Fourteen patients were surgically treated by decompressive craniectomy. Conservative management was done by antiepileptic and antiedema measures. Mostly affected were males (n = 54) followed by females (n = 22). GCS on admission mean value 9. In our study, mortality was 32% with sudden death of three patients due to hypothalamic compression. Hospital stay of the patient was significantly increased with progression of lesion with mean 9 days and p -value less than 0.01. Pillion riders (n = 18) were also affected in our study. Traumatic brain injury-induced coagulopathy (n = 12) was also detected, which was treated by injection tranexamic acid and injection vitamin K, thereby not leading to any death due to coagulopathy with significant p -value less than 0.01. We recommend helmet for both main and pillion rider with strict speeding regulations. [ABSTRACT FROM AUTHOR]

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Background: Foramen magnum (FM) is a crucial aperture situated in the occipital bone and connects the brain to the spinal cord. Its size and dimensions are crucial in understanding a range of disorders, with implications for clinical, surgical, radiological, and forensic fields. We undertook the present study to analyze the morphometry of FM in detail and to compare this data with other similar studies. Methodology: This study analyzed 51 dry human skulls from Northern India of unspecified gender. Morphometric assessments of the FM were conducted, encompassing measurements of its shape, anteroposterior diameter (APD), transverse diameter (TD), FM index (FMI), size, and surface area using digital Vernier calipers. Minimum, maximum, and mean values and standard deviations (SDs) were calculated for each parameter. A comparison with previous studies was conducted. Results: The study established that the most common shape of FM as calculated by the ratio of AP diameter to TD was round (58.8% of specimens) and the majority of FM (41.1%) were narrow according to Martin and Saller classification. Mean APD was 33.71 ± 2.53, and TD was 27.88 ± 1.92; AP diameter was significantly greater than TD (P < 0.05). FMI ranged from 70.54 to 93.55 (mean: 82.92 and SD: 5.63). The mean surface area as calculated by Teixeira’s method was higher compared to Radinsky’s formula; 747.51 ± 96.25 mm2 and 739.93 ± 94.85 mm2, respectively. This difference was not statistically significant (P = 0.68). Conclusion: This study furnishes data on detailed morphometry of FM, a complete knowledge of which is essential for planning surgical procedures for optimal preoperative and postoperative results. It provides an objective definition of the FM’s morphology and highlights the ambiguous role of visual assessment which needs to be reconsidered. The comparison of present morphometric data with other national and international studies further highlights the ethnic and genetic variation of FM.

Anaplastic Large Cell Lymphoma (ALCL) is an uncommon type of Non Hodgkin Lymphoma (NHL). It commonly arises in lymph nodes and can also involve extranodal sites such as the skin, soft tissues, lungs, bones, and liver. Here, a case of Anaplastic Lymphoma Kinase (ALK)-positive ALCL in a 17-year-old male patient who presented with swelling in the frontal and occipital bones is presented. The patient was clinically and radiologically diagnosed with Langerhans Cell Histiocytosis (LCH), and excision of the occipital lesion was performed. Preoperatively, lymphoma was not considered a differential diagnosis. Detailed histopathological examination, immunohistochemistry, and Positron Emission Tomography (PET) scan confirmed the diagnosis of primary bone ALK-positive ALCL. This T-cell NHL is composed of large lymphoid cells with abundant cytoplasm and pleomorphic horseshoe or kidney-shaped nuclei, with characteristic ALK and CD30 positivity. An isolated presentation of ALCL as a primary lesion in the bone is extremely rare. Clinicians and pathologists should be aware of this rare presentation, as prompt diagnosis and proper treatment can lead to favourable outcomes.

Background: Chondroblastoma is a rare, benign bone tumor originating from immature chondrocytes, typically found in the epiphyseal plates of long bones. Its occurrence in the skull, particularly the occipital bone, is extremely rare. Case presentation: We report a 10-year-old girl presenting with paroxysmal dizziness, occipital pain, and a palpable mass. Imaging studies revealed an osteolytic lesion in the occipital bone with a multiloculated appearance, indicating a concomitant aneurysmal bone cyst. The patient underwent craniotomy with complete tumor excision. Postoperative follow-up showed no neurological deficits or complications and MRI confirmed no recurrence. Conclusion: This case highlights the rare presentation of occipital bone chondroblastoma and emphasizes the importance of early surgical intervention for positive outcomes in pediatric patients. [ABSTRACT FROM AUTHOR]

Background: Craniofacial fibrous dysplasia (CFD) typically occurs in the facial bones and anterior cranial vault and can produce both disfigurement and functional limitations for patients disfigurement. Treatment consists of reducing the abnormal bone. Bone contouring can become challenging when the exposure does not extend to the corresponding normal contralateral structures for comparison or when normal landmarks are not available, which may compromise the overall aesthetic outcome. We describe a technique using dynamic mirroring to accurately contour the involved part of the cranium in a case of giant CFD. Observations: A 49-year-old male presented with a giant deforming fibrous dysplasia of the right mastoid and parieto-temporo-occiput that was causing functional limitations due to the size of the bony mass. This was managed with multidisciplinary bony reduction. Several neurovascular structures were in proximity to the areas of planned drilling of the expansile lesion, and dynamic mirroring of the uninvolved left skull was utilized to maximize safety and symmetry of reduction. High-speed drilling of the right occipital bone was performed until the navigation system alerted the surgeon that symmetric depth had been achieved. There were no complications from the procedure and this technique maximized the limits of symmetric reduction without significantly increasing surgical complexity or duration. Lessons: Dynamic mirroring of bony structures in the posterior cranium is not commonly employed in neurosurgical practice. This technique may help improve the aesthetic outcomes of bony reduction in craniofacial dysplasia and a variety of similarly managed bony lesions, contour cranioplasties, and in unilateral craniosynostosis surgery. [ABSTRACT FROM AUTHOR]

Introduction- A noticeable internal occipital crest is visible on the inside surface of the squamous portion of the occipital bone. It descends and bifurcates around the foramen magnum, enclosing a tiny depression known as the vermian fossa. The single or double occipital sinus is located in the falx cerebelli, which is connected to the crest. The fossa houses the inferior vermis of the cerebellum. A bony ridge that divides the vermian fossa into upper and lower parts might give the structure a somewhat triangular shape. There are not many research that describe the morphometric and morphologic characteristics of vermian fossa. Hence, the present study was done to evaluat the morphological and morphometric parameters of vermian fossa and internal occipital crest in the Indian adult human dry skull. Material and method- This study was a cross-sectional study conducted in department of Anatomy of Government Medical College, Handwara and Government Medical College Srinagar for a period of 9 months i.e. 1st September 2023 to 1st June 2014. A total of 140 bones were analysed. Any injured or pathologically altered skulls and occipital bones were excluded from the study. The vermian fossa were examined for their presence and morphology. Internal occipital crest were also seen for its shape and length. The data were recorded and tabulated in SPSS software version 20 and analysed. Result- In the present study the incidence of vermian fossa was found to be 80% of total skull. Vermian fossa was mainly triangular in shape (71.42% cases), followed by quadrangular (8.03% samples) and atypical (20.53% bones). The mean height and width of vermian fossa was measured to be 9.4±4.12 mm and 8.4±3.82 mm respectively. A sharp internal crest was more observed followed by rounded, widened. Ill-defined internal occipital crest was least observed in the present study. The internal occipital crest was 2.82±0.74 cm in length, measured from the internal occipital protuberance to its bifurcation. From the internal occipital protuberance to the posterior margin of the foramen magnum, the internal occipital crest was 4.25±0.46 cm in length on average. Conclusion- It is important for clinicians and radiologists to accurately understand the morphology, morphometry, and changes of the internal occipital crest and vermian fossa when performing diagnostic and therapeutic procedures. It is necessary to investigate variations in typical anatomical features. For this reason, morphologists and anatomists find this important. [ABSTRACT FROM AUTHOR]

Purpose: The topic of osseous variations of the craniocervical junction is a complex morphological and embryological chapter of human anatomy, with a possible impact on neurogical and vascular functionality in this morphological variable region. Material & methods: An until now undescribed anatomical variation of the exoccipital part of the occipital bone has been observed after maceration at the outer skull base of a West-European 68-year-old male body donor. Results: On both sites of the foramen magnum accessory osseous processes were observed that arise from the jugular process and point towards the lateral margin of the foramen magnum. On the left site this process forms a full arc that bridges the condylar fossa completely. Conclusion: The observed osseous bridge over the condylar fossa has not been reported on before and can be explained by the partial persistence of a primordial vertebra between atlas and occipital bone: the Proatlas. The resulting accessory structure may affect due to its topographic conditions the V3-Segment of the vertebral artery and its accompanying nerves, and thus, play a role in diagnosis and therapy of vascular and/or neurological symptoms of head and neck. [ABSTRACT FROM AUTHOR]

Background: Forensic age estimation is a procedure which utilises many methods to estimate the age of both living and deceased individuals, including those who have died in natural disasters or man-made catastrophes. The pattern and closure of spheno-occipital synchondrosis (SOS) fusion, along with subchondral ossification of the mandibular condyle, can be used to estimate age. Aim and objectives: This study aims to estimate age using computed tomographic (CT) images of spheno-occipital synchondrosis fusion (SOS) and mandibular condylar cortication (MCC), and to correlate these findings with chronological age. Materials and methods: The present study included 435 CT images of individuals aged 10-25 years. SOS fusion was assessed using a four-stage system, and MCC was assessed bilaterally using a three-stage system on the sagittal plane. Data on fusion stages and cortication types were entered along with chronological age, and then statistically analysed. Results: SOS fusion stage 2 occurred at similar age in males (19.82 ± 2.67 years) and females (19.23 ± 2.93 years). Earlier fusion of other stages was observed in females by a mean age of 2 years. MCC was completed 1 year earlier in females, with statistically significant differences (p ≤ 0.001). When comparing cortication types and different fusion stages, only type II cortication showed statistically significant differences compared to different fusion stages (p ≤ 0.001). Conclusion: Mandibular condylar cortication (MCC) and spheno-occipital synchondrosis (SOS) fusion were positively correlated with chronological age, suggesting that these parameters can be used as an adjunct method for age estimation. [ABSTRACT FROM AUTHOR]

Purpose: This aim of this study was to investigate the analgesic efficacy and safety of lesser occipital nerve combined with great auricular nerve block (LOGAB) for craniotomy via a suboccipital retrosigmoid approach. Methods: Patients underwent vestibular schwannoma resection via a suboccipital retrosigmoid approach were randomly assigned to receive ultrasound-guided unilateral LOGAB with 5 ml of 0.5% ropivacaine (LOGAB group) or normal saline (NSB group). Numeric rating scale (NRS) scores at rest and motion were recorded within 48 h after surgery. Mean arterial pressure (MAP), heart rate (HR), opioid consumption and other variables were measured secondly. Results: Among 59 patients who were randomized, 30 patients received ropivacaine, and 29 patients received saline. NRS scores at rest (1.8 ± 0.5 vs. 3.2 ± 0.8, P = 0.002) and at motion (2.2 ± 0.7 vs. 3.2 ± 0.6, P = 0.013) of LOGAB group were lower than those of NSB group within 48 h after surgery. NRS scores of motion were comparable except for 6th and 12th hour (P < 0.05) in the LOGAB group. In LOGAB group, MAP decreased significantly during incision of skin and dura (P < 0.05) and intraoperative opoid consumption was remarkably reduced (P < 0.01). Postoperative remedial analgesia was earlier in the NSB group (P < 0.001). No patients reported any adverse events. Conclusion: Among patients undergoing craniotomy for vestibular schwannoma via a suboccipital retrosigmoid approach, LOGAB may be a promising treatment for perioperative analgesia and has the potential to maintain intraoperative hemodynamic stability. Clinical trial registration number: Chictr.org.cn ChiCTR2000038798. [ABSTRACT FROM AUTHOR]

Simple Summary: Simple Summary: This article focuses on conjoined twins in mammals, the theories that account for their development, their various clinical presentations, and the possible molecular implications of their development. We also present two different cases of monocephalic thoracopagus conjoined twin piglets. In both cases, the piglets also had other congenital malformations. The cases are described using necropsy and computed tomography scanning. Conjoined twins are rare congenital malformations that have been reported in mammals. Two different cases are presented in this study. Case No. 1 features monocephalic, thoracopagus-conjoined twin piglets with anencephaly and palatoschisis of the Pietrain breed, and case No. 2 features monocephalic, thoracopagus conjoined twin piglets with palatoschisis and bifid root tongue of a mixed breed. These cases were examined using post-mortem and computed tomography (CT) examinations. In both cases, the conjoined symmetrical twins had a single head, one neck, and fused thoracic cavities, while the abdominal cavities were separated. Similarly, in both cases, they had four forelimbs and four hindlimbs and duplicated foramen magnum. During CT examination, in case No. 1, severe abnormalities were observed in the skull and vertebral column. In the left twin, occult dysraphism was seen from the C2 vertebra until the end of the vertebral column, and in the right twin, from the C3 vertebra until the end of the state vertebral level. In case No. 2, the oral cavity contained a tongue with a bifid root connected with one hyoid bone, and the soft palate presented a small cleft. During CT examination, the parietal bone and the occipital bones were partially duplicated. This case also presented occult dysraphism, but only in the cervical vertebrae, C1–C6 for the left twin and C1–C5 for the right twin. In both cases, abnormalities of the internal organs were revealed during necropsy. Conjoined twins with multiple congenital anomalies presented here enhance our understanding of the various clinical forms of conjoined cases in veterinary medicine. [ABSTRACT FROM AUTHOR]

There have been archaeological and ethnographic reports of artificially modified crania from all continents. Archaeological excavations at the late fifth millennium BCE cemetery of Tol‐e Chega Sofla, located southwest of the Iranian plateau, also revealed these crania. This paper uses the morphometric approach to study Tol‐e Chega Sofla's modified crania. The outlines of normal and modified crania of Chega Sofla and Khuzestan residents' specimens were considered. How accurate is the morphometric approach in identifying and recognizing Chega Sofla's modified skulls from normal ones? Can it recognize small variations in the skull's morphology, such as the flattening of the squamous part of the occipital bone? The results of this method can be compared with descriptive studies. Finally, it is shown that the morphometric approach based on Elliptic Fourier Analysis can identify the deformed skull of Chega Sofla and its intensity, as well as the flattening of the squamous part of the occipital bone. [ABSTRACT FROM AUTHOR]

Post-mortem computed tomography (PMCT) enables the creation of subject-specific 3D head models suitable for quantitative analysis such as finite element analysis (FEA). FEA of proposed traumatic events is an objective and repeatable numerical method for assessing whether an event could cause a skull fracture such as seen at autopsy. FEA of blunt force skull fracture in adults with subject-specific 3D models in forensic pathology remains uninvestigated. This study aimed to assess the feasibility of FEA for skull fracture analysis in routine forensic pathology. Five cases with blunt force skull fracture and sufficient information on the kinematics of the traumatic event to enable numerical reconstruction were chosen. Subject-specific finite element (FE) head models were constructed by mesh morphing based on PMCT 3D models and A Detailed and Personalizable Head Model with Axons for Injury Prediction (ADAPT) FE model. Morphing was successful in maintaining subject-specific 3D geometry and quality of the FE mesh in all cases. In three cases, the simulated fracture patterns were comparable in location and pattern to the fractures seen at autopsy/PMCT. In one case, the simulated fracture was in the parietal bone whereas the fracture seen at autopsy/PMCT was in the occipital bone. In another case, the simulated fracture was a spider-web fracture in the frontal bone, whereas a much smaller fracture was seen at autopsy/PMCT; however, the fracture in the early time steps of the simulation was comparable to autopsy/PMCT. FEA might be feasible in forensic pathology in cases with a single blunt force impact and well-described event circumstances. [ABSTRACT FROM AUTHOR]

Positional plagiocephaly is a deformational cranial flattening frequently treated in pediatric neurosurgical practice. Positional maneuvers and orthotic helmet therapy are preferred therapeutic options for moderate-to-severe forms. Treatment response seems to be age-dependent. Nevertheless, predictive data are vague, and cost-efficiency might be a limiting factor for treatment. The purpose of this study was to investigate the early predictive value of sonographic parameters on the efficacy of orthotic helmet therapy through the assessment of changes in skull shape and correlation of the parameters with caliper cephalometry values and with age. A consecutive cohort of 49 patients < 10 months of age, undergoing orthotic helmet therapy for positional plagiocephaly, was recruited prospectively. The authors routinely assessed the patency of the lambdoid sutures by ultrasound and the following additional skull parameters were measured: suture width, adjacent full bone thickness, adjacent cortical bone thickness and occipital angle. Caliper cephalometric values, as well as demographic and clinical data were collected. Retrospective data analysis showed an inverse relation between both cortical and full skull bone thickness and early treatment efficacy, defined by a reduction in the occipital angle. The improvement of sonographic parameters correlated with the development of cranial caliper cephalometry values. In conclusion, the sonographic assessment of skull bone thickness is a safe and cost-effective tool to predict the early efficacy of orthotic helmet therapy in positional plagiocephaly and might, therefore, help the clinician to foresee the potential evolution of the deformity. [ABSTRACT FROM AUTHOR]

Background. Cocaine is the second most consumed drug worldwide, more than 0.4% of the global population, and has become a real public health problem in recent years. Its inhalation causes significant centrofacial lesions, grouped under the name cocaine‐induced midline destructive lesion (CIMDL). These destructions are due to the conjunction of the vasoconstrictor, local prothrombogenic effects, and cytotoxic effects of cocaine. The ischemia produced by this substance is due to vasoconstriction that leads to nasal tissue necrosis and perforation of the nasal septum secondary to chondral necrosis. Case Presentation. A 36‐year‐old man, previously grappling with cocaine addiction, was hospitalized to undergo comprehensive clinical, microbiological, and radiological examinations because he was suffering from the emergence of crusts and ulceration in the nasal mucosa, accompanied by a palate perforation, a 39°C fever, and chills. Standard bacteriological culture was positive for coagulase‐negative staphylococci and Escherichia coli, while mycological culture was positive for Candida tropicalis. The CT scan images of the sinuses confirmed the presence of palatal perforation and total destruction of the nasal septum, cartilaginous portion, maxillary sinus medial wall, lower and middle turbinates, and middle meatus. Nasal endoscopy revealed an exposition of the bony wall and displayed the exposition of the occipital bone's clivus. A diagnosis of CIMDL was confirmed. Antibiotic therapy was decided based on antibiogram results by the consulting microbiologist. Debridement of necrotic tissue was done by nasal endoscopy with local cleaning and was repetitive during the first week to maintain the best cleanliness possible. The patient was discharged with oro‐nasal hygiene instructions and referred for prosthetic rehabilation. As for the cocaine addiction, the patient was in follow‐up with a psychologist in a specialized centre. Conclusion. The care is multidisciplinary. Psychological help and assistance are essential to guide patients to become cocaine free and to avoid a relapse. Weaning is a prerequisite for surgery. Rehabilitation of speech and swallowing is necessary. Many local flaps or micro‐anastomoses are possible. [ABSTRACT FROM AUTHOR]

The jugular foramen (JF) is located between the temporal and occipital bones. The JF is a primary pathway for venous outflow from the skull and passage of nerves. Variations are common in this region and may have clinical and surgical implications. To analyze the sexual dimorphism and JF morphology in skulls from Northeastern Brazil. 128 human skulls from the Anatomy Laboratory of the Federal University of Paraíba, 64 male and 64 female, were selected and the JFs analyzed for bone septation and the presence of a dome. Data analysis considered P<0.05 as significant. On at least one side, complete septation was observed in 26 skulls (20.3%), incomplete septation in 93 skulls (72.6%) and 61 skulls (47.6%) did not present septation. In 114 skulls (89%), 47.6% female and 41.4% male, have a unilateral presence of the dome and 71 (55.4%) have it bilaterally. Posterolateral compartment diameters and JF area had higher values on the right side in the total sample and separated by sex (P<0.05). Most morphometric variables of the anteromedial compartment were higher in male than in female (P<0.05), fact that was not observed in the posterolateral compartment (P>0.05). This study showed a higher prevalence of complete septation in males compared to females. Morphometric analysis presented a peculiar morphology of the JF in this study. These results suggests that the surgical approach to diseases that affect the JF may be peculiar to the studied population, confirming the importance of morphological analysis of the skull base. [ABSTRACT FROM AUTHOR]

Modified human skulls are among the unique finds recovered from archaeological contexts. They exhibit various forms of deformation, which can be attributed to factors such as diseases, cultural practices, post-burial lithostatic pressure, and life history events. Particularly significant are intentionally deformed skulls, with examples, albeit in small numbers, found throughout Southwest Asia, not to mention the Iranian Plateau. However, these skulls have not received adequate attention in Iran due to problems such as focusing on other research priorities during excavations and the imbalance in the analysis of the various types of excavation findings. Examples of such skulls have been unearthed from the Neolithic sites in the Central Zagros. Recently, excavations at Tol-e Chega Sofla in the Zohreh Plain (Behbahan, Khuzestan) have yielded thirteen skull specimens with deformed proportions in a relatively well-preserved state. Hence, there is an excellent opportunity to study such skulls within the context of the Iranian Plateau. The study of the deformed skulls of Chega Sofla reveals similarities in the methods of skull deformation with the other areas of Southwest Asia. At Tol-e Chega Sofla, the practice of skull deformation using bandages is evident, along with various other traditions of cranial modification. The BG1 mass grave samples show similarities with the Ali Kosh and Seyh Hüyük skulls, while the BG6.1 specimen does not resemble any of the BG1 mass grave skulls and is similar to the modified skull of Burial no.5 in Chagha Sefid. It is worth mentioning that unintentional skull deformation, resulting in the flattening of some parts of the occipital bone, has also been observed in Chega Sofla. [ABSTRACT FROM AUTHOR]

Anaplastic Large Cell Lymphoma (ALCL) is an uncommon type of Non Hodgkin Lymphoma (NHL). It commonly arises in lymph nodes and can also involve extranodal sites such as the skin, soft tissues, lungs, bones, and liver. Here, a case of Anaplastic Lymphoma Kinase (ALK)-positive ALCL in a 17-year-old male patient who presented with swelling in the frontal and occipital bones is presented. The patient was clinically and radiologically diagnosed with Langerhans Cell Histiocytosis (LCH), and excision of the occipital lesion was performed. Preoperatively, lymphoma was not considered a differential diagnosis. Detailed histopathological examination, immunohistochemistry, and Positron Emission Tomography (PET) scan confirmed the diagnosis of primary bone ALK-positive ALCL. This T-cell NHL is composed of large lymphoid cells with abundant cytoplasm and pleomorphic horseshoe or kidney-shaped nuclei, with characteristic ALK and CD30 positivity. An isolated presentation of ALCL as a primary lesion in the bone is extremely rare. Clinicians and pathologists should be aware of this rare presentation, as prompt diagnosis and proper treatment can lead to favourable outcomes. [ABSTRACT FROM AUTHOR]

Epidermoid cysts are uncommon accounting for less than 1% of all intracranial tumors. Among them, giant intradiploic epidermoid cysts of the posterior fossa i.e. those exceeding 5 cm are an even rarer entity. Here we report on the complete resection of a 7 cm posterior fossa epidermoid cyst involving the occipital bone in a 32-year-old female presenting with an acute on chronic exacerbation of headaches and vertigo. Complete resection including the cyst wall is crucial in preventing recurrence and malignant transformation. We add to limited existing data by reporting on the first systematic review to date assessing 25 cases of giant epidermoid cysts of the posterior fossa to discuss presentation, clinical and radiographic features and definitive management strategies.

Recent years have witnessed a rapidly growing interest in CVJ bony abnormalities, and a qualitative and quantitative analysis of relevant literatures is necessary. This study aims to identify and summarize the published articles related to craniovertebral junction bony abnormalities, to analyze and visualize the current research trends and major contributors. We collected data from Web of Science, excluding certain article types. Two researchers screened articles for relevance. Data were organized with EndnoteX9, and analyzed using VOSviewer and CiteSpace for co-authorship, co-occurrence, keyword burst, and co-citation analyses to identify research trends and collaborations. A total of 2,776 articles were included, revealing an increasing trend in annual publications of CVJ bony abnormalities. The USA was the leading country. King Edward Memorial Hospital was the most prolific institution, and Seth GS Medical College had the most citations. The Spine is the most popular journal with the highest number of publications and citations. Professor Goel Atul from India emerged as the most influential pioneer in this field. Keyword analysis highlighted surgical techniques, diagnosis, and anatomy as the primary research hotspots and Fixation, Placement, and Basilar invagination gradually become the new research trend. However, there is a relative weakness in basic research and epidemiology. This study provides valuable insights into the current research trends and critical contributors in CVJ bony abnormalities, guiding evidence-based decisions and fostering international collaborations to advance knowledge in this field. [ABSTRACT FROM AUTHOR]

This study aimed to examine the mechanism of occipital condyle fractures (OCFs), their clinical symptoms, computer tomography (CT) scan findings, treatment options, and classification. A retrospective analysis was conducted on 43 patients with OCFs who were admitted to our neurosurgery center between 2017 and 2023. The investigation covered their clinical symptoms, CT scan results, and treatment outcomes. It was found that 25.6% of the patients suffered from severe craniocerebral injuries with Glasgow Coma Scale (GCS) scores of 3–8 points, 9.3% had moderate injuries with GCS scores of 9–12 points, and 65.1% exhibited mild injuries with GCS scores of 13–15 points. Of these patients, 90.7% showed improvement upon discharge, 4.7% succumbed to their injuries, and another 4.7% developed paraplegia. Symptoms indicative of OCF in individuals with CCJ injuries included neck pain, swelling, cranial nerve palsy, and posterior pharyngeal wall swelling. Frequently observed complications in OCF patients included cerebral contusion, occipital bone fractures, and skull base fractures. Employing thin-layer CT scans of the CCJ area, along with sagittal and coronal CT reconstructions, is essential for identifying OCFs. The fractures were classified into 3 types based on the Anderson-Montesano classification, which, when modified, provides enhanced treatment guidance. OCFs are predominantly present in cases of high-energy trauma, with high-resolution thin-layer CT scans serving as the preferred diagnostic method. The application of the modified Anderson-Montesano classification, distinguishing between stable and unstable fractures, facilitates the determination of suitable treatment strategies. Stable OCFs can be managed using a rigid neck brace, while unstable OCFs may require Halo-vest frame fixation or surgical intervention. [ABSTRACT FROM AUTHOR]

Background: Obtaining accurate knowledge of the anatomical structure of the skull helps in ontogenetic studies and determining sexual polymorphisms. Objectives: This study uses anatomical dissection and radiography to develop a size standard for the skull of the Saanen goat; information that will be applied to clinical evaluation and decision‐making. Methods: A total of 14 adult Saanen goat skulls (7 male and 7 female goats) were taken from the slaughterhouse and transferred to the clinic of the Faculty of Veterinary Medical Teaching Hospital, Urmia University, Urmia, Iran. Radiographs of each skull were prepared in the dorsal–ventral, left and right lateral recumbency. These heads were then brought over to the anatomy department, where the chosen morphometric traits were assessed and their means recorded. Results: According to the findings of this study, the dorsal view of the skull revealed an incisive raphe and a widespread foramen of the nose. In the ventral view, the incisive bones were observed in the most cranial region of the skull. The base of the occipital bone was relatively large, and the jugular process was well‐developed. In the lateral view, the incisive bone was extended to the cranial and had a narrow process on the dorsal surface. Regarding infra‐orbital foramen, it was visible in the maxillary bone. Moreover, the lacrimal bone was perceived as a distinct bone. Conclusion: The precise standards acquired in this study can be utilized to interpret the findings and make clinical decisions about the normal and abnormal size of the bones that make up the skulls of the Saanen goats. [ABSTRACT FROM AUTHOR]

This article presents a comparative study on the anatomical assessment of the foramen magnum (FM) among the South Indian population using CT scans. The study found that the most common shape of the FM in both dry skulls and CT scan images was hexagonal. There were no significant differences in measurements between the two methods. The study provides valuable information for surgeons and medical professionals. The document is a list of references to various studies and articles related to the anatomical assessment of the foramen magnum and spinal cord, which can be useful for researchers studying these features in different populations. [Extracted from the article]

Objective We retrospectively reviewed the CT and MRI features of patients with benign osteoblastoma in the calvarium and skull base (CSBOB). Methods Nine cases of pathologically confirmed benign CSBOB were analysed retrospectively. The patients had undergone CT and/or MRI. Tumour location, size, and imaging features were reviewed and recorded. Results The patients included four males and five females with a mean age of 27.0 years (age 14-40 years). The tumours were located in the frontal bone in 3 patients, the occipital bone in 3 patients, and in the parietal bone, sphenoid bone, and skull base in 1 patient each. On CT, the tumours measured 5.1 ± 3.3 (1.8-8.4) cm. Seven tumours were shown to have caused expansile bony destruction with an eggshell appearance and varying degrees of calcification or matrix mineralization. Multiple septa were observed in 5 tumours. Intracranial growth was observed in 5 tumours. On MRI, 7 tumours showed heterogeneous hypo- to isointensity on T1WI. Heterogeneous high signal patterns with low signal rims and septa were observed in 6 tumours on T2WI, and 4 showed a fluid-fluid level. On contrast-enhanced imaging, 6 tumours showed peripheral and septal enhancement, and 2 showed the dural tail sign. Conclusions Benign CSBOB is a rare tumour characterized by expansile bony destruction, septa, a sclerotic rim and calcification or matrix mineralization on CT and MRI. Advances in knowledge The findings from this study contribute to a better understanding of benign CSBOB and provide valuable imaging features that can aid in its diagnosis and differentiation from other tumours in the calvarium and skull base. [ABSTRACT FROM AUTHOR]

This article, published in the Anatolian Journal of General Medical Research, discusses a case report of prostate cancer metastasis to the occipital bone. Prostate cancer typically metastasizes to the pelvic lymph nodes and axial skeleton, making metastasis to the occipital bone rare. The article highlights the use of 68Ga-PSMA PET/CT scanning, which has been shown to be more sensitive than conventional imaging techniques in detecting prostate cancer. The authors emphasize the importance of this imaging method in cases where metastasis cannot be demonstrated by conventional methods, as it can influence treatment decisions. [Extracted from the article]

Background: Spheno-occipital synchondrosis is a growth center that is involved in craniofacial development. Since osteogenesis of this synchondrosis occurs relatively later than other synchondroses, it has been taken into account for age estimation in forensics. This study aimed to evaluate spheno-occipital synchondrosis using Cone-Beam Computed Tomography (CBCT) in an Iranian population. Methods: In this cross-sectional study, 148 CBCT images (76 women and 72 men) of patients aged 7-25 years, with a mean age of 19.92±6.3 years, were assessed by two radiologists to analyze the sphenooccipital synchondrosis fusion degree using a four-stage system. In addition, the third molar development degree (Demirjian index) was assessed in panoramic and cross-sectional views of CBCT images. The correlation between spheno-occipital synchondrosis fusion degree and age was obtained. Multiple regression analysis was used for age estimation using spheno-occipital synchondrosis fusion degree and third molar development degree (Demirjian index). Intra-observer and inter-observer coefficients of agreements were also measured. IBM SPSS Statistics 20.0 was used. Results: There was a positive correlation between spheno-occipital synchondrosis fusion degree and age (r=0.75, p<0.001). The multiple regression model provides a more robust model than when each age marker is utilized individually. The kappa coefficient was 0.53 for inter-observer agreement and 0.77-0.92 for intra-observer agreement. Conclusion: Assessing the four-stage spheno-occipital synchondrosis fusion degree was not a robust method; however, combined with the third molar development (Demirjian index), it could be considered as an appropriate marker for age estimation in 7-25-year-old Iranian population. [ABSTRACT FROM AUTHOR]

Occipitalization of atlas is an osseous anomaly of the craniovertebral junction, which occurs at the base of the skull in the region of the foramen magnum. It is the fusion of first cervical vertebra with the occipital bone of the skull. A 16-year-old patient reported with chief complaint of irregularly placed teeth. Routine lateral cephalogram assessment revealed the presence of fusion between first cervical vertebrae (C-1) and base of skull. The radiographic investigation revealed the presence of fusion along with the clinical findings of short neck, short face, cleft palate, missing teeth, and pain during neck extension and flexion. Such cases of craniocervical anomaly can cause orthopedic and neurological problems like abnormal posture of head, restricted neck movements, cervical pain, pain in extremities, wasting of muscles, and convulsions. The comprehensive radiographic assessment of all structures visible in cephalogram of orthodontic patient can help in identification of such anomalies and sensitize the patients about symptomatic or asymptomatic condition. [ABSTRACT FROM AUTHOR]

An 11‐year‐old, female‐neutered beagle was presented with a growing soft tissue mass arising within the deep tissues of the left cranial cervical region. At presentation, facial asymmetry was evident along with palpable lymphadenomegaly. Magnetic resonance imaging demonstrated a locally invasive cervical mass with intracranial invasion through focal osteolysis of the occipital bone. After antihistamine administration, cytology confirmed mast cell tumour (MCT) with metastasis to local lymph nodes and liver. The owner chose to pursue lomustine and prednisolone, which were dispensed, but, before home administration, prolonged seizures/status epilepticus occurred prompting euthanasia. Postmortem examination confirmed a high‐grade MCT associated with, and infiltrating through, muscle, calvarium, dura mata, leptomeninges and the underlying brain. We present the clinical, imaging, and pathological findings of an unprecedented case of extracranial MCT tumour causing osteolysis of an imperforate flat bone (occipital bone) and intracranial invasion. [ABSTRACT FROM AUTHOR]

Penetrating brain injuries are rare events in modern times. In this article we present the case of an adolescent with a knife, lodged in the occipital region needing surgical care. The patient was conscious, cooperative, and vitally stable with a Glasgow coma scale (GCS) of 15/15 with no lateralizing signs. Computed tomography (CT) scan of the brain demonstrated the knife blade in the suboccipital bone with suspicious injury to the right transverse sinus. General anesthesia was provided and airway secured in a lateral position using a video laryngoscope. Surgery was performed in the prone position using the Mayfield head holder. All measures to prevent secondary brain injury were taken. The patient remained vitally stable during surgery and could be extubated after surgery. Planning and preparation are vital for the smooth conduct of the case. [ABSTRACT FROM AUTHOR]

The Dicynodontia (Therapsida: Anomodontia) is one of the most successful Permo-Triassic terrestrial tetrapod clades and the oldest specimens are recorded from the middle Permian Eodicynodon Assemblage Zone of South Africa. Their fossil record is abundant and species-rich across Pangea. By contrast, the fossil record of the basal-most anomodonts, which includes non-dicynodont anomodonts and early forms of dicynodonts, is patchy and their morphology and phylogeny are deduced from relatively few specimens. Discovered in 1982 and described in 1990, the holotype of Eodicynodon oelofseni (NMQR 2913) is one of the better-preserved early anomodont specimens. However, it has been suggested that E. oelofseni does not belong to the genus Eodicynodon. Here, using CT-scanning and 3D modeling, the skull of Eodicynodon oelofseni, Patranomodon nyaphulii and Eodicynodon oosthuizeni are redescribed. In the framework of this study, the application of 3D scanning technology to describe anatomical structures which were previously inaccessible in these fossils has enabled detailed redescription of the cranial morphology of the basal anomodonts Patranomodon, Eodicynodon oelofseni and £ oosthuizeni and led to a greater understanding of their cranial morphology and phylogenetic relationships. Based on an anatomical comparison and phylogenetic analyses (Bayesian and cladistics) the phylogenetic relationships of basal anomodonts are reassessed and it is suggested that NMQR 2913 does not belong to the genus Eodicynodon but likely represents a separate genus basal to other dicynodonts. A new genus is erected for NMQR 2913. This presents one of the first applications of Bayesian Inference of phylogeny on Therapsida. [ABSTRACT FROM AUTHOR]

Background: Transcranial alternative current stimulation (tACS) refers to a promising non-invasive technique to improve brain functions. However, owing to various stimulation parameters in the literature, optimization of the stimulation is warranted. In this study, the authors aimed to compare the effect of tACS electrode montages on occipital responses. Methods: In three montage sessions (i.e., Oz-Cz, Oz-cheek, and sham), 10 healthy young adults participated, receiving 20-min 2-mA alpha-tACS. Pattern- reversal visual evoked potentials (VEPs) were measured before tACS (T0), immediately after (T20), and 20 min (T40) after tACS. Normalized changes in time-domain features (i.e., N75, P100 amplitudes, and P100 latency) and frequency-domain features [i.e., power spectral density in alpha (PSDα) and beta (PSDβ) bands] were evaluated. Results: In contrast to our hypothesis, the occipital response decreased immediately (T20) after receiving the 20-min tACS in all montages in terms of P100 amplitude (p = 0.01). This reduction returned to baseline level (T0) in Oz-cheek and sham conditions but sustained in the Oz-Cz condition (T40, p = 0.03) after 20 min of tACS. The effects on N75 amplitude and P100 latency were statistically insignificant. For spectral analysis, both PSDα and PSDβ were significantly increased after tACS at T20, in which the effect sustained until T40. However, there was no differential effect by montages. There was no significant difference in the occurrence of sensations across the montages. The effectiveness of the blinding is supported by the participants' rate of guessing correctly. Conclusion: This study revealed an immediate inhibitory effect of tACS, regardless of the montages. This inhibitory effect sustained in the Oz-Cz montage but faded out in other montages after 20 min. [ABSTRACT FROM AUTHOR]

This article, published in the Journal of Neurological Surgery, discusses a rare case of spheno-occipital enchondroma in a pediatric patient with Ollier's disease. Enchondromas are cartilaginous tumors that typically occur in long bones but can also be found in the flat bones of the skull. Multiple lesions are associated with rare skeletal dysplastic disorders, and there is a risk of transformation to chondrosarcoma. The patient in this case underwent surveillance imaging and eventually had the lesion surgically removed. The article emphasizes the importance of long-term surveillance and multidisciplinary management for patients with enchondromatosis. [Extracted from the article]

Autosomal dominantly inherited neurofibromatosis type I (NF1) is a systemic disorder caused by a mutation of a gene on chromosome 17q11.2 and characterized by multiple café-au-lait spots, lentiginous macules, Lisch nodules of the iris, and tumors of the nervous system. Bony manifestations such as scoliosis, dysplasia of the greater sphenoidal wing, tibial pseudoarthrosis, short stature, and macrocephaly have been reported in approximately 50% of patients. However, calvarial bone defects are rare. After screening 324 articles, 23 cases (12 adult and 11 pediatric patients) of occipital bone defects in NF1 patients were selected. All patients had a single/multiple bone defect over the lambdoid suture. Adjacent benign plexiform neurofibromas were observed in 14 patients (60.8%, 7 adults and 7 children); one adult patient was diagnosed with neurofibrosarcoma. Meningoencephalocele over the occipital defect was noted in 8 cases (34.78%, all adults). Cranioplasty was performed in only 17.39% of patients. Histologic examination was performed in 7 of the 15 patients with associated neurofibromas/neurofibrosarcomas. Biopsy of the bone margins surrounding the defect was performed in only one case. Pathologic examination of the herniated parieto-occipital or cerebellar tissue was not performed in any of the patients studied. We report the case of a 9-year-old girl with NF1 and a significant occipital bone defect and performed a systematic review of the relevant literature to highlight the challenges in treating this condition and to investigate the underlying mechanisms contributing to bone defects or dysplasia in NF1. [ABSTRACT FROM AUTHOR]

Purpose: To characterise dynamic postural stability of gait in patients with vestibular hypofunction (PwVH) using a sensor-based assessment while performing dynamic tasks and to correlate the results of this evaluation with clinical scales. Methods: This cross-sectional study involved 22 adults between 18 and 70 years old from a healthcare hospital centre. Eleven patients suffering from chronic vestibular hypofunction (PwVH) and eleven healthy controls (HC) were evaluated through a combined inertial sensor-based and clinical scale assessment. Participants were equipped with five synchronised inertial measurement units (IMUs) (128 Hz, Opal, APDM, Portland, OR, USA): three IMUs were located on the occipital cranium bone, near the lambdoid suture of the head, at the centre of the sternum, and at L4/L5 level, just above the pelvis, and were used to quantify gait quality parameters, while the other two were located slightly above lateral malleoli and used to perform stride and step segmentation. Three different motor tasks were performed in a randomized order: the 10-m Walk Test (10mWT), the Figure of Eight Walk Test (Fo8WT) and the Fukuda Stepping Test (FST). A set of gait quality parameters related to stability, symmetry and smoothness of gait were extracted from IMU data and correlated with the clinical scale scores. PwVH and HC results were compared to test for significant between-group differences. Results: Significant differences were found for the three motor tasks (10mWT, Fo8WT and FST) when comparing PwVH and HC groups. For the 10mWT and the Fo8WT, significant differences between the PwVH and HC groups were found for the stability indexes. Considering the FST, significant differences between the PwVH and HC groups were also found in the stability and symmetry of gait. A significant correlation was found between the Dizziness Handicap Inventory and gait indices during the Fo8WT. Conclusions: In this study, we characterized the dynamic postural stability alterations during linear, curved, and blindfolded walking/stepping in PwVH combining an instrumental IMU-based with traditional clinical scales approach. Combining instrumental and clinical evaluation for dynamic stability of gait alterations in PwVH is useful in thoroughly evaluating the effects of unilateral vestibular hypofunction. [ABSTRACT FROM AUTHOR]

Introduction: The occipital condyles are located lateral to anterior half of foramen magnum. Being the important component of craniovertebral region, occipital condyles are exposed to variety of clinical conditions. These clinical conditions may need surgical interventions for their treatment. In transcondylar approach to craniovertebral junction lesions partial occipital condylectmies are done commonly. It has been reported after such condylectomies that there have occurred post-operative atlanto occipital joint instability and hypoglossal nerve palsies. These post-operative complications have been attributed to population specific variations in the occipital condyles. Hence it is important to have meticulous knowledge of the occipital condyles. Aims: The aim of this study was to measure the morphometric parameters of the occipital condyles like length, width, height, anterior intercondylar distance (AID) and posterior intercondylar distance (PID) of the Indian population and to compare them with the other populations. Materials and Methods: The study was conducted in Government Medical College Srinagar, J&K, India, on 198 occipital condyles (76 occipital bones and 23 articulated skulls). Measurements were done with the help of Vernier's calliper. Mean and standard deviation of the morphometric parameters were analysed and comparison was done. Results: The length of occipital condyles on the right side was 22.86 + 3.05mm and on the left side it was 22.76 + 2.80 mm with the mean of 22.81 + 2.92mm. The width on the right side was 12.23 + 1.51mm while on the left side it was found to be 11.43mm + 1.36mm with the mean of 11.83 + 1.43mm. the height of the occipital condyles on the right side was found to be 9.37 + 1.29mm and on the left side it was 9.16 + 1.15mm with the mean of 9.27 + 1.22 mm. the mean anterior intercondylar distance (AID) was found to be 19.57 + 2.81mm while the mean value of posterior intercondylar distance (PID) was found to be 39.62 + 4.23mm. Conclusion: the mean values of all the parameters in the study showed side variations values were found more on the right side than that of left side. there was also difference in these values between the Indian and the other populations for successful surgeries on the occipital condyles, the surgeon must take care of these variations. The study thereby forms the morphometric reference to the surgeons to carry out successful surgeries. [ABSTRACT FROM AUTHOR]

Background: Temporal bone squamous cell carcinoma (TBSCC) is a very rare condition. The prognosis is dismal for advanced tumors. Due to its rarity, information in the literature is scarce. Here, we report a unique case of TBSCC with cerebellar invasion and hydrocephalus. Case Description: A 46-year-old reported right-sided hearing loss and a painful right retroauricular mass for 4 months. Magnetic resonance imaging revealed a 8.7 × 7.6 × 6.4 cm mass invading the right temporal and occipital bones. After a biopsy and 3 surgical procedures over 6 months, the diagnosis of TBSCC was obtained. Due to invasion of the cerebellar tissue and obstructive hydrocephalus, a ventriculoperitoneal shunt was performed. The patient was referred for adjuvant radiotherapy. However, palliative care was initiated due to tumor progression. Conclusion: We report a case of advanced TBSCC with poor prognosis despite surgical treatment and radiotherapy. More data are necessary to provide new and better treatment to these patients. [ABSTRACT FROM AUTHOR]

Introduction: The knowledge of Jugular foramen is important to neurosurgeons while performingsurgeries related to Jugular foramen because, in case of tumor invasion, all structures are not clearly seenand hence correct knowledge is required when approachingsuch tumors or other related diseases. The diameters of Jugular foramen are different in different sex, races, and age. Objective: This osteological study was to provide complete knowledge of Jugular foramen in Indian population with some other characteristics like dome and separation in Jugular foramen. Material and Methods: 68 skulls were obtained from anatomy department, NHLMMC and BJMC. Anteroposterior and transverse diameter of jugular foramen was measured using vernier calipers. The presence of dome shaped bony roof and septa was observed using magnifying glass. We did not include bones with broken or damaged Jugular foramen. Results: We found dome in 4 skulls on right side and in 1 skull on left side. Separation was found complete in 11 skulls, partial in 81 skulls and absent in 44 skulls. In 55.8%, size of the foramen was greater on right side than left. Average anteroposterior diameter was0.82cm and average transverse diameter was 1.10 cm. [ABSTRACT FROM AUTHOR]