Surgical And Radiologic Anatomy[JOURNAL]
Sun
200 papers
A systematic review of pes anserinus variations, their anatomical types, prevalence, and clinical reflections.
Çavuş F, Erbek E, Bolatlı G
Surg Radiol Anat · 2025 Dec · PMID 41430502 · Publisher ↗
PURPOSE: The pes anserinus (PA) is formed by the sartorius, gracilis, and semitendinosus tendons, serving as a common graft source in knee surgery. However, variations in tendon convergence, accessory slips, and insertio...
PURPOSE: The pes anserinus (PA) is formed by the sartorius, gracilis, and semitendinosus tendons, serving as a common graft source in knee surgery. However, variations in tendon convergence, accessory slips, and insertion sites may directly affect surgical outcomes. This systematic review aimed to analyze the morphological variations of the PA, their prevalence, and clinical implications. METHODS: Following PRISMA 2020 guidelines, a systematic search was performed in PubMed, Scopus, Web of Science, and Google Scholar using the terms “pes anserinus,” “anatomy,” “morphology,” and “variation.” Eligible studies included human cadaveric or imaging-based investigations published in English after 2000. Study quality was assessed using the AXIS tool. RESULTS: Fourteen studies comprising 769 knees were included. The pooled prevalence of the classical tri-tendinous configuration was 62%. Variations were most frequently observed in the semitendinosus tendon, while gracilis showed inconsistent rates across populations, and sartorius variations were rare. Accessory bands were reported in up to 100% of some series. These findings are clinically significant, as unrecognized variants may lead to graft insufficiency, stripper slippage, or diagnostic errors in imaging. CONCLUSION: The PA exhibits wide interindividual variability beyond the classical configuration. Awareness of these variations is essential for surgeons and radiologists to prevent complications. Larger studies incorporating biomechanical analyses are needed to better clarify the clinical importance of PA variations.
Morphologic and volumetric analysis of the isthmus in mandibular first molars of a Malaysian subpopulation: a micro-CT study.
Al-Rammahi HMJ, Ahmed HMA, Chai WL
Surg Radiol Anat · 2025 Dec · PMID 41430010 · Publisher ↗
PURPOSE: This study investigated the morphology of isthmus in mandibular first molar of a Malaysian subpopulation. METHOD: A total of 140 double-rooted mandibular first molars were scanned using micro-computed tomography...
PURPOSE: This study investigated the morphology of isthmus in mandibular first molar of a Malaysian subpopulation. METHOD: A total of 140 double-rooted mandibular first molars were scanned using micro-computed tomography. Fan et al. classification was used to classify the isthmus morphology. The chi-square test was used to compare the qualitative variables. The independent samples t-test and Mann Whitney U test were used to compare the quantitative variables. RESULTS: The prevalence of isthmus was 77.1%. The mesial root had the majority of isthmuses [135 (89.4%)]. Of these, 65.2% were "Mixed" type. The distal roots had only 16 (10.6%) of all isthmuses. Of these, 12 (75%) were "Mixed" type. No significant difference in the type of isthmus between the mesial and distal roots (p = 0.335). However, a significant association was found between root type and the presence of isthmus (p < 0.001). There was no significant difference neither in the volume of canal part with isthmus (p = 0.703 for sheet and 0.149 for mixed types) nor in the percentage volume (p = 0.601 for sheet and 0.299 for mixed types) between the mesial and distal roots in sheet and mixed isthmus types. CONCLUSION: In this population, the mandibular first molar showed a high complexity in the isthmus anatomy, especially in the mesial root.
Ulnar nerve dimensions at entrapment sites in cadavers.
Ghosh A, Suganya G
Surg Radiol Anat · 2025 Dec · PMID 41429930 · Publisher ↗
PURPOSE: The ulnar nerve might undergo compression due to traumatic or non-traumatic pathological conditions or altered anatomy within the extent of the distal arm to the proximal hand, leading to ulnar neuropathy. There...
PURPOSE: The ulnar nerve might undergo compression due to traumatic or non-traumatic pathological conditions or altered anatomy within the extent of the distal arm to the proximal hand, leading to ulnar neuropathy. There are certain anatomical sites where the increased ulnar nerve cross-sectional area (CSA) values indicate probable compression and can be diagnosed by the high-resolution Ultrasonography (USG) or Magnetic Resonance Imaging (MRI) in symptomatic patients. The ulnar nerve CSA varies across the population, and there is limited data available for the Indian population. Hence, we aimed to evaluate the CSA measurement of the ulnar nerve in various predefined anatomical sites. METHODS: The CSA of the ulnar nerve was studied in 64 (34 Male, 30 Female) formalin-fixed cadaveric upper limbs in various predefined anatomical sites. The statistical analysis was done using Microsoft Excel and Stata 12 software. RESULTS: The average CSA of the ulnar nerve was 4.77 ± 2.21 mm at the level of the medial epicondyle and 2.21 ± 0.86 mm at the level of the wrist. The CSA values were higher in males than in females. This study has also reported the distances of the branch points of the ulnar nerve supplying the flexor carpi ulnaris and flexor digitorum profundus muscles, the dorsal cutaneous and palmar cutaneous branches from the nearest bony landmarks. CONCLUSION: Thus, this study provides a baseline value of ulnar nerve CSA for the East Indian population, which might help clinicians to diagnose ulnar neuropathy.
Morphometric evaluation of superficial anastomatic veins of the brain using venous MR angiography.
Ozkal B, Candan B, Top E … +1 more , Yasın M
Surg Radiol Anat · 2025 Dec · PMID 41419690 · Publisher ↗
PURPOSE: This study aimed to perform a morphometric analysis of the main superficial anastomotic veins of the brain the vein of Trolard (VT), vein of Labbé (VL), and superficial Sylvian vein (SSV) using magnetic resonanc...
PURPOSE: This study aimed to perform a morphometric analysis of the main superficial anastomotic veins of the brain the vein of Trolard (VT), vein of Labbé (VL), and superficial Sylvian vein (SSV) using magnetic resonance venography (MRV), and to compare the findings with the literature to assess clinical and surgical implications. METHODS: MRV scans of 154 individuals (105 females, 49 males; mean age: 42.12 ± 16.39 years) obtained between 2020 and 2024 were retrospectively analyzed. The presence, length, midpoint diameter, course, drainage pattern, dominance, and interconnections of the VT, VL, and SSV were evaluated bilaterally. Statistical analyses included chi-square, independent t-test, Mann-Whitney U, Pearson correlation, and Holm-Bonferroni correction. RESULTS: VT was the most prevalent vein, observed in 88.3% of right and 76.6% of left hemispheres, most often located in the postcentral region. VL was present in 74.0% (right) and 66.9% (left), draining mainly into the transverse sinus. SSV was identified in 74.3% (right) and 63.6% (left). Significant associations were found between right VL and SSV (p = 0.0003) and between left VT and right SSV (p = 0.0385, not significant after correction). VT predominated in the right hemisphere and VL in the left. No correlation was found between age and morphometric parameters. CONCLUSION: Superficial cerebral veins exhibit marked anatomical variability. Understanding their course and drainage is essential for neurosurgical planning, particularly in lateral and trans-Sylvian approaches. This study provides updated morphometric data to help minimize venous injury and support future anatomical and surgical research.
Distance to the spinal canal and vertebral body from the insertion point of percutaneous pedicle screws in the lumbar spine: radiographic anatomy on computed tomography images for a safe and efficient procedure.
Maki Y, Aoyama T
Surg Radiol Anat · 2025 Dec · PMID 41419648 · Publisher ↗
PURPOSE: This study aimed to evaluate the distance for the safe and efficient insertion of percutaneous pedicle screws (PPSs) in lumbar fixation surgery. METHODS: On lumbar computed tomography thin-slice images parallel...
PURPOSE: This study aimed to evaluate the distance for the safe and efficient insertion of percutaneous pedicle screws (PPSs) in lumbar fixation surgery. METHODS: On lumbar computed tomography thin-slice images parallel to the cranial vertebral endplate, two different insertion points of the PPS were defined: (1) the lateral wall of the pedicle (defined as the LP) and (2) the angle between the transverse process and superior articular process (TS). From these points, we measured the distance to the inner wall of the pedicle (A) and the posterior wall of the vertebral body (B). The distance was measured bilaterally from L1 to L5 of consecutive 60 patients. RESULTS: The results of PL-A (the mean distance ± standard deviation) from the L1 level to the L5 were 17.9 ± 3.0, 18.1 ± 2.9, 18.9 ± 3.1, 18.7 ± 3.4, and 19.9 ± 3.3 mm, respectively. Those of PL-B were 24.1 ± 3.5, 23.2 ± 3.4, 23.0 ± 3.8, 22.1 ± 4.1, and 21.9 ± 3.8 mm. The results of TS-A were 17.9 ± 2.6 mm, 17.6 ± 2.2, 18.0 ± 2.3, 16.3 ± 2.2, and 17.1 ± 2.3, whereas those of TS-B were 22.8 ± 2.6 mm, 21.6 ± 2.3, 21.2 ± 2.1, 18.6 ± 2.1, and 18.3 ± 2.2, respectively. Moreover, the PL-A, PL-B, TS-A, and TS-B of all L1-L5 were 18.7 ± 3.2, 22.9 ± 3.8, 17.4 ± 2.4, and 20.5 ± 2.9 mm. CONCLUSION: This study can contribute to the safe and efficient insertion of the lumbar PPS.
Bilateral retropharyngeal course of the common, internal, and external carotid arteries: implications for neck dissection.
Sakai S, Kikuta S, Kusukawa J
Surg Radiol Anat · 2025 Dec · PMID 41388089 · Publisher ↗
PURPOSE: To report a case of tongue cancer with an exceptionally rare bilateral retropharyngeal course of the common, internal, and external carotid arteries, and to underscore the critical role of preoperative imaging f...
PURPOSE: To report a case of tongue cancer with an exceptionally rare bilateral retropharyngeal course of the common, internal, and external carotid arteries, and to underscore the critical role of preoperative imaging for performing a safe neck dissection. METHODS: An 81-year-old woman was diagnosed with squamous cell carcinoma of the right tongue. Preoperative contrast-enhanced computed tomography revealed a unique vascular anomaly, with the bilateral carotid systems coursing retropharyngeally. Based on this detailed radiological assessment, she underwent a partial glossectomy and a modified radical neck dissection under general anesthesia. RESULTS: Guided by the preoperative three-dimensional anatomical evaluation, the carotid arteries were identified and preserved early in the procedure, which was completed without abnormal hemorrhage (estimated blood loss: 76 mL). The final pathological diagnosis was pT2N0M0. The patient's postoperative course was complicated by multiorgan failure secondary to sepsis, unrelated to any vascular injury, and she ultimately expired. The cervical wound healing was uneventful. CONCLUSION: Neck dissection can be performed safely even in the presence of complex carotid artery anomalies. Meticulous preoperative radiological evaluation and tailored surgical planning are indispensable for averting catastrophic vascular complications. Head and neck surgeons must maintain a high index of suspicion for such anatomical variations.
Skull base foramina provide a route for the exit of brain lymphatic vessels from the human skull.
Altınöz D, Rahimova Z, Gürses İA … +2 more , Kurtoğlu F, Çavdar S
Surg Radiol Anat · 2025 Dec · PMID 41381901 · Publisher ↗
PURPOSE: The brain lymphatic vessels (LV) drain fluids, metabolic waste, and immune cells. The abnormal accumulation of toxic substances causes neurodegenerative, cerebrovascular diseases, and brain tumors. Despite their...
PURPOSE: The brain lymphatic vessels (LV) drain fluids, metabolic waste, and immune cells. The abnormal accumulation of toxic substances causes neurodegenerative, cerebrovascular diseases, and brain tumors. Despite their intracranial importance, the precise extracranial exit routes of brain LVs remain poorly characterized. We evaluated the presence of LVs in the dural samples overlying the foramina/canals (superior orbital fissure, foramen rotundum, foramen ovale, Meckel's cave, internal acoustic meatus, foramen lacerum, jugular foramen, and hypoglossal canal) using immunohistochemistry. METHODS: Samples from six human cadavers were stained with Podoplanin, LYVE-1 (LV endothelial markers), and CD31 (vascular endothelial marker). RESULTS: The LVs were observed in all the dura samples except the internal acoustic meatus. The dura overlying the Meckel's cave had the largest LVs, and the smallest ones were observed in the superior orbital fissure. Further, the dura overlying the jugular foramen had the largest FCs, and the smallest ones were observed in Meckel's cave. The diameters of the LVs may indicate their efficiency in the transfer of lymphatic fluid. Fluid channels of varying diameters were closely localized to the LVs. CONCLUSION: Our findings can increase the understanding of how LVs exit the skull and contribute to the neuropathophysiological processes. Knowledge of the lymphatic network is important for identifying metastatic sites of various cancers. Furthermore, special attention should be given during regional surgery to preserve lymphatic drainage.
Morphological characteristics of the retrocalcaneal bursal wedge of Kager's fat pad.
Sakamoto K, Edama M, Ishigaki T … +3 more , Takabayashi T, Kawakami J, Toriumi T
Surg Radiol Anat · 2025 Dec · PMID 41381888 · Publisher ↗
PURPOSE: This study aimed to clarify the morphological characteristics of the retrocalcaneal bursal wedge of Kager's fat pad (KFP-W). METHODS: Fifty legs from 27 cadavers were examined. The KFP-W was categorized as eithe...
PURPOSE: This study aimed to clarify the morphological characteristics of the retrocalcaneal bursal wedge of Kager's fat pad (KFP-W). METHODS: Fifty legs from 27 cadavers were examined. The KFP-W was categorized as either a single-lobule or double-lobule type based on the presence or absence of separation into medial and lateral lobules. Separation of the retrocalcaneal bursa was evaluated based on the presence of intrabursal connective tissue. The length, width, and thickness of the KFP-W were also measured. RESULTS: The single- and double-lobule types were each observed in 25 ankles (50%). In the single-lobule type, the KFP-W was positioned laterally on the superior facet, leaving a portion of the medial aspect of the facet uncovered, and no separation of the retrocalcaneal bursa was observed. In the double-lobule type, bursal separation was present in 16 ankles (64%), and the lateral lobule was significantly longer, wider, and thicker than the medial lobule (p < 0.05). CONCLUSION: These findings suggest that the KFP-W is primarily situated lateral to the Achilles tendon insertion, with a smaller or absent structure medially. Therefore, the medial region may exhibit reduced shock-absorbing capacity due to the less prominent KFP-W.
Correlation between facial artery types and the diameter of its main trunk in Korea cadavers.
Choi NR, Gil YC
Surg Radiol Anat · 2025 Dec · PMID 41366554 · Publisher ↗
PURPOSE: The branching patterns of the facial artery (FA) vary significantly between individuals, affecting treatment efficacy and complication rates in facial surgery and anti-aging procedures. Identifying FA types preo...
PURPOSE: The branching patterns of the facial artery (FA) vary significantly between individuals, affecting treatment efficacy and complication rates in facial surgery and anti-aging procedures. Identifying FA types preoperatively is challenging. This study aimed to assess the feasibility of predicting FA type by classifying it into five types (I–V) based on distribution and correlating them with the diameter of the main trunk (MT). METHODS: Thirty-seven Korean cadavers (74 sides) were dissected to assess FA branching pattern, MT diameter, and number of branches. (IRB No. CBNU-2023–4630). RESULTS: Type III was most frequent (59.5%). Type IV showed a detoured (DT) branch connected to the angular artery. The mean MT diameter was 3.05 ± 0.69 mm, increasing significantly from Types I to V (p < 0.05). Types I or II were found when MT diameter was ≤ 2.0 mm, and Type V when ≥ 4.0 mm. MT diameter correlated positively with FA type (r = 0.620), branch number (r = 0.527), and DT branch presence (r = 0.415) (p < 0.01). In sex-specific comparisons, men had significantly larger MT, winding part, and nasolabial fold diameters than women (p < 0.05). In lateral comparisons, the right MT diameter was greater than the left (p < 0.05), whereas the diameters of each arterial branch showed no significant differences between sexes or between sides. CONCLUSIONS: MT diameter may serve as an indicator for predicting FA type and branching pattern. Even a simple Doppler ultrasound measurement of MT diameter may help anticipate FA distribution and reduce vascular complications in clinical settings.
A novel classification of the basilar artery bifurcation height and the impact of fetal-type posterior cerebral artery: a radioanatomical study with implications for neurosurgical planning.
Triantafyllou G, Papadopoulos-Manolarakis P, Piagkou M … +3 more , Tsakotos G, Galzio R, Luzzi S
Surg Radiol Anat · 2025 Dec · PMID 41366069 · Publisher ↗
PURPOSE: The vertical location of the basilar artery bifurcation (BAB) is a crucial factor in determining the best surgical approach for basilar tip (BAT) aneurysms. Although anatomical variants, such as the fetal-type p...
PURPOSE: The vertical location of the basilar artery bifurcation (BAB) is a crucial factor in determining the best surgical approach for basilar tip (BAT) aneurysms. Although anatomical variants, such as the fetal-type posterior cerebral artery (FPCA), have been linked to aneurysm formation, their impact on BAB height remains unclear. METHODS: A retrospective anatomical-imaging analysis of 250 high-resolution computed tomography angiograms (CTAs) was conducted to measure the vertical distance from the BAT to the clinoidal line (CL). A dominant posterior communicating artery and/or a hypoplastic or absent P1 segment defines the FPCA. RESULTS: BATs were classified into four types based on their BAT-CL distance, with Type 2 BATs (within ± 5 mm of the CL) being the most common. The mean BAT-CL distance was + 2.88 ± 4.8 mm. An FPCA was identified in 74 patients (29.6%). The BAT was significantly lower in all fetal-type subgroups than in patients with typical PCA anatomy (p < 0.005). Bilateral FPCA exhibited the lowest BAT-CL distance (- 0.9 ± 3.2 mm). An FPCA is significantly associated with a caudally positioned BAT. CONCLUSIONS: This finding can assist in surgical planning by predicting aneurysm height based on vascular configuration. In such cases, the pretemporal trans-cavernous approach through extended pterional craniotomy may offer safer and more direct access, thereby reducing surgical morbidity. These results support incorporating vascular variants in preoperative assessments to optimize personalized neurosurgical strategies.
Optic nerve course and its association with lateral lamella: relevance for endoscopic sinus surgery.
Tulaci T, Tulaci KG, Canakci H … +4 more , Ozgur EO, Sengül SM, Akay E, Hizli O
Surg Radiol Anat · 2025 Dec · PMID 41361551 · Publisher ↗
PURPOSE: To investigate the association between the anatomical course of the optic nerve within the sphenoid and posterior ethmoid sinuses (Delano classification) and anterior skull base morphology, particularly lateral...
PURPOSE: To investigate the association between the anatomical course of the optic nerve within the sphenoid and posterior ethmoid sinuses (Delano classification) and anterior skull base morphology, particularly lateral lamella length and olfactory fossa depth. METHODS: Paranasal sinus CT scans from 192 patients (384 hemi-sinuses) were retrospectively reviewed. The course of the optic nerve was categorized using the Delano classification (types 1-4). Lateral lamella length and Keros classification were assessed for each case. Statistical comparisons were performed using ANOVA, post-hoc Tukey tests, and Chi-square analysis. RESULTS: Lateral lamella length significantly differed among the Delano types (p = 0.001). Delano type 3 and type 4 sinuses demonstrated significantly longer lateral lamella compared to type 1 (p = 0.026 and p = 0.016, respectively). Additionally, a significant variation in Keros classification was observed across Delano groups (p = 0.025), with higher Delano types showing increased prevalence of Keros type 3. These findings suggest that optic nerve protrusion is associated with elongation of the lateral lamella and deepening of the olfactory fossa. CONCLUSION: This is the first study to demonstrate a significant anatomical correlation between Delano classification and anterior skull base morphology. As optic nerve protrusion into the sphenoid sinus increases, adjacent skull base structures-particularly the lateral lamella-become elongated, potentially heightening the risk of iatrogenic injury during endoscopic sinus surgery. Combined use of Keros and Delano classifications in preoperative imaging may enhance surgical risk stratification and improve patient safety.
Demographics with purpose: a scientific necessity, not a social stigma.
Omotoso BR, Harrichandparsad R, Lazarus L
Surg Radiol Anat · 2025 Dec · PMID 41361011 · Publisher ↗
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Anatomical landmarks and angulation of the subclavian vessels: a CT-based morphometric study of the clavicular safety corridor.
Muñoz-Leija D, Lozano-Carrillo LC, Castillo-Treviño JN … +8 more , Vílchez-Cavazos JF, Muñoz-Leija MA, Pinales-Razo R, Guzmán-López S, Teran-Garza R, Quiroga-Garza A, Elizondo-Omaña RE, Gutiérrez-de-la-O J
Surg Radiol Anat · 2025 Dec · PMID 41350497 · Publisher ↗
The present study aims to describe the morphometric relationship of the subclavian vein and artery to the clavicle and their angular orientation, with a particular focus on improving the safety of interventional procedur...
The present study aims to describe the morphometric relationship of the subclavian vein and artery to the clavicle and their angular orientation, with a particular focus on improving the safety of interventional procedures by bringing new anatomical landmarks. The costoclavicular region is a critical anatomical corridor where the subclavian vein, subclavian artery, and brachial plexus cords pass beneath the clavicle, partially protected by the subclavius muscle. Precise knowledge of clavicle-vessel relationships is essential, as previous studies have reported considerable variability in the measured distances between the clavicle and adjacent vascular structures, particularly in the context of trauma or surgical fixation. This study aimed to define morphometric parameters to establish a safer anatomical corridor for clinical interventions. A cross-sectional study was conducted using contrast-enhanced computed tomography (CT) scans of adult patients (≥ 18 years). Each clavicle was divided into 13 reference points. At each point, we measured clavicular thickness, the distance from the inferior border of the clavicle to the anterior surface of the subclavian vein and artery, vessel diameters, and the angular relationship between the clavicle and vessels. Side- and sex -related differences were analyzed. A total of 150 participants (75 men, 75 women) were included. All participants were of Hispanic ethnicity, representative of the northeastern Mexican population. The greatest clavicular thickness was observed in men on the right side (14.4 ± 1.6 mm), whereas the shortest distance to the subclavian vein occurred in women on the right side (5.9 ± 2.1 mm). The subclavian vein was significantly larger in men on the right side (14.8 ± 2.7 mm). Significant sex- and side-dependent variations were identified in clavicle dimensions, vessel diameters, and vessel-clavicle distances and angulations. The point of closest proximity between the clavicle and the subclavian vein was consistently located at reference point 3/13 which corresponds to the medial third of the clavicle, located approximately at the costoclavicular region. At this site, the vein was reached at an average depth of ~ 13 mm when the needle was directed 20° cranially relative to the inferior clavicular border. These parameters define a practical "safety cone" that may improve the success and safety of subclavian vein catheterization, particularly in settings where ultrasound guidance is unavailable.
Clinical presentation of the accessory soleus muscle: a quantitative systematic review.
Yammine K, ElKayem E, Tannoury E … +2 more , Helou M, Assi C
Surg Radiol Anat · 2025 Dec · PMID 41350425 · Publisher ↗
BACKGROUND: The accessory soleus muscle (ASM) is a rare anatomical variant and the most common accessory muscle in the leg/ankle region. Though asymptomatic in most cases, ASM could exhibit clinical manifestations leadin...
BACKGROUND: The accessory soleus muscle (ASM) is a rare anatomical variant and the most common accessory muscle in the leg/ankle region. Though asymptomatic in most cases, ASM could exhibit clinical manifestations leading to medical consultation. Since no evidence-based synthesis has been conducted yet, this review aims to collate pooled quantitative data on the clinical presentation and management of ASM. METHODS: The electronic databases of Medline and Embase were searched from inception, met the inclusion criteria. Only clinical cases of symptomatic ASM were included. Clinical and cadaveric incidental findings of ASM were excluded. RESULTS: Forty-one articles met the inclusion criteria, comprising 134 ASM in 122 patients. The clinical presentation of the ASM was as follows: exertional pain (60%), posteromedial ankle swelling (59%), foot numbness/dysesthesia (5.2%), soft non-tender mass (30%), a tender mass in 9%, a soft mass that becomes hard on plantarflexion (44%), and positive Tinnel's sign (11.2%). The diagnostic modalities used were: x-rays (62.7%), MRI (52.2%), CT scan (24.6%), ultrasound (12.7%) and EMG studies (13.4%). Out of 128 treated cases, conservative management was used in 36.7%, and surgery in 50% of cases including fasciotomy in 22.6%, excision in 20.3%, posterior tibial nerve decompression in 7.8%, and a combined procedure in 1.7%. Regardless of the treatment modality, all surgical patients were satisfied. CONCLUSIONS: The findings of this review would help clinicians to better recognize, diagnose and treat the rare condition of a symptomatic accessory soleus muscle.
Peripheral segment of the cerebral cortical vein: a magnetic resonance imaging study.
Tsutsumi S, Kawai S, Sugiyama N … +3 more , Ueno H, Suzuki M, Ishii H
Surg Radiol Anat · 2025 Dec · PMID 41331393 · Publisher ↗
PURPOSE: There have been no anatomic reports documenting the peripheral segments of the cerebral cortical veins (PSCVs). This study aimed to explore them using magnetic resonance imaging (MRI). METHODS: A total of 100 pa...
PURPOSE: There have been no anatomic reports documenting the peripheral segments of the cerebral cortical veins (PSCVs). This study aimed to explore them using magnetic resonance imaging (MRI). METHODS: A total of 100 patients underwent thin-sliced coronal T2-weighted MRI, 2.0 mm in thickness, performed in both the supine and prone positions. For comparison, two cadaveric heads were dissected to observe the PSCVs. RESULTS: In the dissected hemispheres, the PSCVs were consistently attached to the lateral surfaces of the cerebral gyri. In 100 patients who underwent MRI, the PSCVs were attached variably to the cerebral gyri or bottom of the sulci, in subdivided cerebral areas. The length and thickness of the PSCVs showed high variability. Compared to the medial two-thirds of the middle cerebral part, the PSCVs were more frequently found in the medial two-thirds of the anterior cerebral part. Also, compared to the medial two-thirds of the posterior cerebral region, PSCVs were more frequent in the medial two-thirds of the middle cerebral region. Furthermore, the PSCVs and attached cerebral gyri did not undergo any morphological alterations or displacement in response to positional changes from the supine to the prone position. CONCLUSIONS: PSCVs may be most frequently distributed over the anteromedial cerebral hemisphere, followed by the middle part of the hemisphere. In the cranial cavity, these veins may serve to anchor the cerebral hemisphere floating in the cerebrospinal fluid.
Anatomical variability of the hypoglossal dural pori and canal: double hypoglossal dural porus is the main anatomical configuration in the German population.
Klaeger JN, Schmeisser MJ, Schumann S
Surg Radiol Anat · 2025 Dec · PMID 41331156 · Full text
PURPOSE: The hypoglossal nerve innervates all the extrinsic and intrinsic tongue muscles except the palatoglossus. Hypoglossal rootlets emerge from the brainstem via the pre-olivary sulcus, fuse to fiber bundles which pi...
PURPOSE: The hypoglossal nerve innervates all the extrinsic and intrinsic tongue muscles except the palatoglossus. Hypoglossal rootlets emerge from the brainstem via the pre-olivary sulcus, fuse to fiber bundles which pierce the cranial dura mater, and leave the skull through the hypoglossal canal. While the presence of two hypoglossal fiber bundles piercing the dura separately, as well as the presence of exostoses in the hypoglossal canal are well known phenomena, their co-occurrence and the prevalence of these variations in the German population has poorly been described. METHODS: 101 formaldehyde fixated skull base sides (52 right, 49 left) from the collection of the Institute of Anatomy Mainz, Germany, were used in this study. The course of the hypoglossal nerve from the dural porus to the entrance in the hypoglossal canal was investigated by macroscopical dissection. RESULTS: In 32.7% (n = 33) only one dural porus on each side was present. In most cases (65.3%, n = 66) two hypoglossal dural pori were visible and in 2% (n = 2) three dural pori. Five types of hypoglossal canal configuration could be distinguished: Type 1: Simple canal (34.7%); Type 2: Exostosis at the superior margin (superior lingula, 31.7%); Type 3: Exostosis at the inferior margin (inferior lingula, 4%); Type 4: Both a superior and an inferior lingula (3%); Type 5: Complete osseus bridge (26.7%). Additionally, we described a rare case of a triplication of the hypoglossal canal. CONCLUSION: A double hypoglossal dural porus is the most common anatomical configuration in the German population.
Another look at the intertendinous connections: a dynamic study based on palpation, ultrasonography, and dissection.
Murillo-González J, Naredo E, Pascual-Ramos V … +6 more , Mérida-Velasco JR, Olivas-Vergara O, Contreras-Yáñez I, Piñeiro-Bugallo I, Torres-Rosello A, Canoso JJ
Surg Radiol Anat · 2025 Dec · PMID 41331133 · Publisher ↗
PURPOSE: To explore the feasibility of a dynamic exploration of the intertendinous connections using palpation to capture their haptic characteristics and movement during finger flexion, and ultrasonography to reveal the...
PURPOSE: To explore the feasibility of a dynamic exploration of the intertendinous connections using palpation to capture their haptic characteristics and movement during finger flexion, and ultrasonography to reveal their structure, relationships, and precise measurements. METHODS: The authors utilized palpation and ultrasonography, blind to each other’s findings, as well as anatomical dissection. RESULTS: Both palpation and ultrasonography revealed the intertendinous connections, except for their thickness, which was noted by the latter. Palpation also showed the distal excursion of the intertendinous connections during finger flexion and increased tension during finger separation. Dissection provided anatomical details of tendons, intertendinous connections, and their distal excursion with metacarpophalangeal joint flexion with limitations posed by tissue preservation. CONCLUSIONS: Palpation and ultrasonography, with a background of dissection, offered new and complementary insights into the intertendinous connections, which previously had been subject to a painstaking morphological approach. As key take-home messages, the authors submit that palpation and ultrasonography, which are eminently dynamic and cost-effective, apply to the intertendinous connections. More generally, palpation and ultrasonography are largely untapped source of hypotheses worthy of anatomical investigation.
Clinical and anatomical perspective of the meningohypophyseal trunk: a comprehensive review.
Mazurek A, Popadynets V, Ghosh SK … +3 more , Dyrcz J, Iskra T, Walocha J
Surg Radiol Anat · 2025 Dec · PMID 41331128 · Full text
PURPOSE: Meningohypophyseal trunk (MHT) is a small branch of cavernous part of the internal carotid artery (ICA) which trifurcates into tentorial, inferior hypophyseal and dorsal meningeal arteries. MHT often provides th...
PURPOSE: Meningohypophyseal trunk (MHT) is a small branch of cavernous part of the internal carotid artery (ICA) which trifurcates into tentorial, inferior hypophyseal and dorsal meningeal arteries. MHT often provides the feeder artery for skull-base meningiomas. Therefore, this arterial trunk is frequently chosen for preoperative embolization. Due to its clinical importance we summarized information about its anatomical variations and relevant clinical attributes pertaining to embolization procedures as reported in literature. MATERIALS AND METHODS: We performed a systematic review of PubMed and Embase databases according to the PRISMA 2020 guidelines. Studies with anatomical description of the MHT or embolization of this vessel were included. RESULTS: From 150 identified studies, 49 full-texts were analyzed and 25 of them were included in this systematic review. Seventeen of included studies described morphological features of the MHT (origin from the ICA, complete/incomplete type) and 8 studies depicted embolization of the MHT. The most common origin of the MHT was the posterior loop of the cavernous ICA and in majority of cases complete trifurcated type of the MHT was observed. Embolization of the MHT was successful in nearly all of the patients with lower risk of complications when balloon protection was used. CONCLUSIONS: Relevant morphological details about MHT might facilitate neurosurgeons during planning procedures involving cavernous sinus area but there is no significant correlation between anatomy of the MHT and risk of possible complications. Choice of method and embolic agent during embolization may be approached with customized perspective of the operator. This may be associated with reduced risk of complications and better outcome from clinical viewpoint.
Correction: Persistent primitive lateral basilovertebral anastomosis-rethinking vertebrobasilar junction fenestration.
Triantafyllou G, Papadopoulos-Manolarakis P, Arkoudis NA … +3 more , Velonakis G, Samolis A, Piagkou M
Surg Radiol Anat · 2025 Dec · PMID 41329338 · Full text
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Direct muscular connection between the orbicularis oculi and risorius muscles: a case report.
Park HJ, Kim SB
Surg Radiol Anat · 2025 Nov · PMID 41272372 · Publisher ↗
PURPOSE: The orbicularis oculi (OOc) and risorius muscles are typically regarded as distinct anatomic and functional units with no known direct muscular connections. Although rare variants of the facial musculature have...
PURPOSE: The orbicularis oculi (OOc) and risorius muscles are typically regarded as distinct anatomic and functional units with no known direct muscular connections. Although rare variants of the facial musculature have been reported, their implications for facial dynamics and clinical practice remain underexplored. To the best of our knowledge, this report presents a previously undescribed direct link between the OOc and risorius muscles, highlighting their potential functional and clinical significance. METHODS: This report presents an anatomical variant in which the lateral fibers of the OOc muscle descend abnormally, running lateral to the zygomaticus major and in close proximity to the zygomatic retaining ligaments (McGregor's patch). RESULTS: In the mid-cheek region, several of these fibers blended with the superior fibers of the risorius muscle, forming a direct muscular connection at the lateral boundary of the facial expression muscles, and ultimately inserting into the modiolus. This bilateral anatomical variant was not accompanied by other notable anomalies in the adjacent facial structures. CONCLUSION: This report presents a previously undescribed direct connection between the OOc and risorius muscles. This configuration may allow for coordinated movement between eyelid closure and mouth corner retraction, thereby facilitating complex and integrated facial expressions. Clinically, recognition of this variation is important for procedures such as botulinum toxin injection, musculo-aponeurotic system-based facial surgery, and facial reconstruction, as it may influence both functional and aesthetic outcomes.
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