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A variant branching pattern of arch of aorta
Abstracts / Journal of the Anatomical Society of India 65S (2016) S98–S142
the latter case it was completed by radial artery. An incomplete superficial palmar arch has been found in one hand of a cadaver during routine dissection of palm. Superficial palmar arch has attracted the interest of anatomists and surgeons performing hand surgeries. Conflicts of interest The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.370 64 Unequal cerebral hemispheres with polygyria – A rare finding with clinical implications P.A. Athira Lady Hardinge Medical College & Associated Hospitals, New Delhi, India Polygyria is a developmental anomaly of the brain characterized by development of numerous microgyri. It is a neuronal migration disorder present in specific neurological diseases like multiple sclerosis, Fukuyama congenital muscular dystrophy, Arnold Chiari malformation, etc. Its association with unequal size of cerebral hemispheres is a rare presentation. The present case particularizes the clinical significance of this uncommon association. 10% formalin fixed brain specimen of a 50 years old male cadaver was procured for routine educational cadaveric dissection. The pattern of the sulci and gyri of the two cerebral hemispheres were studied extensively and photographs taken. The measurements of the two cerebral hemispheres were noted by digital Vernier caliper and compared. We observed asymmetry of cerebral hemispheres and an abnormal pattern of sulci and gyri on the medial surface of the left cerebral hemisphere in the occipital and frontal lobes. An H-shaped sulcus was observed in the cuneus region of the left cerebral hemisphere (LCH). The length of the corpus callosum (CC) and frontal-occipital pole diameter of the LCH was more than that of the right while vertical dimensions taken from genu, body and splenium of the CC to superomedial border of the LCH were less than that of the right. The gyral pattern of the right hemisphere appeared normal. The rare presentation seen in the present case is associated with numerous neurological deficits like mental retardation, seizures, spastic hemiparesis or quadriparesis, etc. which may be of relevance to physicians, neurologists, neurosurgeons and radiologists. Conflicts of interest The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.371 65 A variant branching pattern of arch of aorta Samata Goyal J.L.N. Medical College Ajmer, Rajasthan, India Variations of the branches of aortic arch are due to alteration in the development of certain branchial arch arteries during embryonic period. Three classical branches spring from convex aspect of the aortic arch: the brachiocephalic trunk, left common carotid artery and left subclavian artery. This branching pattern is the most
S115
common in about 65% of aortic arch branching pattern. The left common carotid artery varies in origin more than the right. The present report describes anomalies in branching of the aortic arch identified in an adult male cadaver during dissection classes for medical undergraduates in the Department of Anatomy J.L.N. Medical College Ajmer. In the present case the left common carotid artery was seen originating from the arch of aorta and the left vertebral artery directly from the arch of the aorta proximal to the origin of the left subclavian artery. He had no past medical history suggestive of cardiovascular disease. The cause of death was non-cardiovascular disease. The cadaver was formalin-fixed. Knowledge of variations in branching pattern of the aortic arch is of great importance in patients who have to undergo four vessel angiography, aortic instrumentation, or supra aortic thoracic, head and neck surgery. The anomalies of the aortic arch branching pattern could lead to cerebral abnormalities by altering the pattern of flow in cerebral vessels. Knowledge of abnormal branches originating from the aortic arch is also important in the diagnosis of intracranial aneurysms and subarachnoid hemorrhage. Conflicts of interest The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.372 66 Study of variation in sacralisation of lumbar vertebrae Sinchal Datta D Y Patil Medical College, Nerul, Navi Mumbai, Maharashtra, India The purpose of the study was observation of sacralisation of lumbar vertebra and its variations. A naked eye observation of sacrum and a simple scoring system was done based on the anatomical variation. 50 randomly collected dry sacra of both male and female were examined. Scoring given as: full body of lumbar vertebra fused with sacrum – 2; half body fusion of lumbar vertebra with sacrum (hemi fused) – 1; bilateral fusion of transverse processes – 2; one sided transverse process fused – 1. 10% samples were found with sacralisation. 2% showed complete sacralisation with fusion of full vertebral body and bilaterally fused transverse processes (score 4), 4% showed fusion of full body and unilaterally fused transverse process (score 3). 4% showed fusion of half body (hemi fused) with unilaterally fused transverse process (score 2). Sacralisation studies have shown racial and regional variation from 2% to 14%. The low sample size may not be truly indicative of the no of cases of sacralisation. Sacralisation may remain clinically insignificant at the beginning but later on symptoms and signs appear as back pain at young age due to compressed L5 nerve, sciatic pain, disc herniation or prolapse at L4–L5 level, disc degeneration, difficulty in normal delivery, difficulty in assessing intervertebral space to inject spinal anesthesia or withdrawal of CSF. Conflicts of interest The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.373
the latter case it was completed by radial artery. An incomplete superficial palmar arch has been found in one hand of a cadaver during routine dissection of palm. Superficial palmar arch has attracted the interest of anatomists and surgeons performing hand surgeries. Conflicts of interest The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.370 64 Unequal cerebral hemispheres with polygyria – A rare finding with clinical implications P.A. Athira Lady Hardinge Medical College & Associated Hospitals, New Delhi, India Polygyria is a developmental anomaly of the brain characterized by development of numerous microgyri. It is a neuronal migration disorder present in specific neurological diseases like multiple sclerosis, Fukuyama congenital muscular dystrophy, Arnold Chiari malformation, etc. Its association with unequal size of cerebral hemispheres is a rare presentation. The present case particularizes the clinical significance of this uncommon association. 10% formalin fixed brain specimen of a 50 years old male cadaver was procured for routine educational cadaveric dissection. The pattern of the sulci and gyri of the two cerebral hemispheres were studied extensively and photographs taken. The measurements of the two cerebral hemispheres were noted by digital Vernier caliper and compared. We observed asymmetry of cerebral hemispheres and an abnormal pattern of sulci and gyri on the medial surface of the left cerebral hemisphere in the occipital and frontal lobes. An H-shaped sulcus was observed in the cuneus region of the left cerebral hemisphere (LCH). The length of the corpus callosum (CC) and frontal-occipital pole diameter of the LCH was more than that of the right while vertical dimensions taken from genu, body and splenium of the CC to superomedial border of the LCH were less than that of the right. The gyral pattern of the right hemisphere appeared normal. The rare presentation seen in the present case is associated with numerous neurological deficits like mental retardation, seizures, spastic hemiparesis or quadriparesis, etc. which may be of relevance to physicians, neurologists, neurosurgeons and radiologists. Conflicts of interest The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.371 65 A variant branching pattern of arch of aorta Samata Goyal J.L.N. Medical College Ajmer, Rajasthan, India Variations of the branches of aortic arch are due to alteration in the development of certain branchial arch arteries during embryonic period. Three classical branches spring from convex aspect of the aortic arch: the brachiocephalic trunk, left common carotid artery and left subclavian artery. This branching pattern is the most
S115
common in about 65% of aortic arch branching pattern. The left common carotid artery varies in origin more than the right. The present report describes anomalies in branching of the aortic arch identified in an adult male cadaver during dissection classes for medical undergraduates in the Department of Anatomy J.L.N. Medical College Ajmer. In the present case the left common carotid artery was seen originating from the arch of aorta and the left vertebral artery directly from the arch of the aorta proximal to the origin of the left subclavian artery. He had no past medical history suggestive of cardiovascular disease. The cause of death was non-cardiovascular disease. The cadaver was formalin-fixed. Knowledge of variations in branching pattern of the aortic arch is of great importance in patients who have to undergo four vessel angiography, aortic instrumentation, or supra aortic thoracic, head and neck surgery. The anomalies of the aortic arch branching pattern could lead to cerebral abnormalities by altering the pattern of flow in cerebral vessels. Knowledge of abnormal branches originating from the aortic arch is also important in the diagnosis of intracranial aneurysms and subarachnoid hemorrhage. Conflicts of interest The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.372 66 Study of variation in sacralisation of lumbar vertebrae Sinchal Datta D Y Patil Medical College, Nerul, Navi Mumbai, Maharashtra, India The purpose of the study was observation of sacralisation of lumbar vertebra and its variations. A naked eye observation of sacrum and a simple scoring system was done based on the anatomical variation. 50 randomly collected dry sacra of both male and female were examined. Scoring given as: full body of lumbar vertebra fused with sacrum – 2; half body fusion of lumbar vertebra with sacrum (hemi fused) – 1; bilateral fusion of transverse processes – 2; one sided transverse process fused – 1. 10% samples were found with sacralisation. 2% showed complete sacralisation with fusion of full vertebral body and bilaterally fused transverse processes (score 4), 4% showed fusion of full body and unilaterally fused transverse process (score 3). 4% showed fusion of half body (hemi fused) with unilaterally fused transverse process (score 2). Sacralisation studies have shown racial and regional variation from 2% to 14%. The low sample size may not be truly indicative of the no of cases of sacralisation. Sacralisation may remain clinically insignificant at the beginning but later on symptoms and signs appear as back pain at young age due to compressed L5 nerve, sciatic pain, disc herniation or prolapse at L4–L5 level, disc degeneration, difficulty in normal delivery, difficulty in assessing intervertebral space to inject spinal anesthesia or withdrawal of CSF. Conflicts of interest The author has none to declare. http://dx.doi.org/10.1016/j.jasi.2016.08.373