Medulla Oblongata and Cranial Nerves.

2006 ◽  
pp. 175-185
Author(s):  
G. L. Freeman
Keyword(s):  
Medulla Oblongata ◽  
Cranial Nerves

Microsurgical resection of a glioblastoma multiforme of the medulla oblongata with intraoperative subcortical stimulation and mapping

2019 ◽  
Vol 1 (2) ◽  
pp. V1
Author(s):  
Sima Sayyahmelli ◽  
Jian Ruan ◽  
Bryan Wheeler ◽  
Mustafa K. Başkaya
Keyword(s):  
Glioblastoma Multiforme ◽  
Surgical Resection ◽  
Medulla Oblongata ◽  
Cranial Nerves ◽  
The Body ◽  
Fine Motor ◽  
Surgical Video ◽  
Inferior Aspect ◽  
Hyperintense Signal ◽  
Microsurgical Resection

Primary glioblastoma multiforme tumors of the medulla oblongata are rare, especially in the adult population. Perhaps due to this rarity, we are not aware of any previous reports addressing the resection of these tumors or their clinical outcomes.In this surgical video, we present a 43-year-old man with a 1-month history of left-sided paresthesia. The paresthesia initiated in the left hand, along with weakness and reduced fine motor control, and then spread to the entire left side of the body. He had recent weight loss, imbalance, difficulty in swallowing, and hoarseness in his voice. He also had a diminished gag reflex, and significant atrophy of the right side of the tongue with an accompanying deviation of the uvula and fasciculations of the tongue. MRI showed an infiltrative expansile mass within the medulla with peripheral enhancement and central necrosis. In T2/FLAIR sequences, a hyperintense signal extended superiorly into the left inferior aspect of the pons and left inferior cerebellar peduncle and inferiorly into the upper cervical cord.The decision was made to proceed with surgical resection. The patient underwent a midline suboccipital craniotomy with C1 laminectomy for surgical resection of this infiltrative expansile intrinsic mass in the medulla oblongata, with concurrent monitoring of motor and somatosensory evoked potentials and monitoring of lower cranial nerves IX, X, XI, and XII. A gross-total resection of the enhancing portion of the tumor was performed, along with a subtotal resection of the nonenhancing portion. The surgery and postoperative course were uneventful. Histopathology revealed a grade IV astrocytoma. The patient received radiation therapy.In this surgical video, we demonstrate important steps for the microsurgical resection of this challenging glioblastoma multiforme of the medulla oblongata.The video can be found here: https://youtu.be/QHbOVxdxbeU.

scholarly journals Further research in the area of the central endings of the X-th pair of cranial nerves

2020 ◽  
Vol VI (2) ◽  
pp. 155-168
Author(s):  
V. P. Osipov
Keyword(s):  
Vagus Nerve ◽  
Medulla Oblongata ◽  
Cranial Nerves ◽  
Vagus Nerves ◽  
The Way

In 1896, I published the research of the central endings of the vagus nerve. Continuing with the study in the indicated direction, I received, in addition to confirming the results of the first study, some results that were not devoid of interest; These results were not new for me, because on the microscopic preparations that served as materials for the first work, there are corresponding changes in the area of ​​the central endings of the vagus nerve; on the contrary, further research was undertaken by me with the aim of checking the constancy of some changes in the medulla oblongata, advancing every step of the way behind the overwhelming vagus nerves. Thus, the present work is, as it were, an addition to the first one, containing the results of research that were not included in the first work.

The medulla oblongata and the cranial nerves.

2011 ◽  
pp. 183-194
Author(s):  
Graydon LaVerne Freeman
Keyword(s):  
Medulla Oblongata ◽  
Cranial Nerves

Continuous Laryngoscopic Vocal Cord Monitoring for Vascular Malformation Surgery in the Medulla Oblongata: Technical Note

Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 232-235 ◽  
Author(s):  
Yoshinori Tamano ◽  
Hiroshi Ujiie ◽  
Takakazu Kawamata ◽  
Tomokatsu Hori
Keyword(s):  
Postoperative Complications ◽  
Evoked Potentials ◽  
Vocal Cord ◽  
Medulla Oblongata ◽  
Fourth Ventricle ◽  
Cranial Nerves ◽  
Posterior Pharyngeal Wall ◽  
Spontaneous Respiration ◽  
Pharyngeal Wall ◽  
Lower Cranial Nerves

Abstract OBJECTIVE Resection of lesions located in the medulla oblongata may result in significant morbidity. The most lethal complications are swallowing disturbances, which can lead to aspiration pneumonia. To prevent this problem, the lower cranial nerves can be mapped with recording needles placed in the posterior pharyngeal wall and the tongue. However, mapping alone is not sufficient to preserve the lower cranial nerves and swallowing functions. To overcome this problem, we attempted to devise a method to intraoperatively monitor vocal cord movements with a laryngoscope. We used this method, in addition to other types of brainstem mapping, in three cases. METHODS Recording needles were inserted into the posterior pharyngeal wall and the tongue, to record the responses of Cranial Nerves IX and XII. A laryngoscope was inserted orally, for direct observation of vocal cord movements, and was maintained until the end of the operation. The floor of the fourth ventricle was stimulated with a monopolar stimulator. Somatosensory evoked potentials, auditory evoked potentials, and motor evoked potentials were simultaneously monitored. RESULTS We were able to confirm synchronized vocal cord adduction with stimulation of the expected vagal trigonum location and to monitor rhythmic vocal cord movements during spontaneous respiration. In all three cases, we removed the lesions without postoperative complications. CONCLUSION In addition to intraoperative vocal cord monitoring with a laryngoscope, we could safely determine the optimal location for the first incision in the floor of the fourth ventricle. Potentially lethal postoperative complications can be avoided with brainstem mapping and vocal cord monitoring.

scholarly journals Research of the central beginnings and endings of the accessory nerve (N. accessorius Willisii)

2020 ◽  
Vol VI (1) ◽  
pp. 118-138
Author(s):  
V. P. Osipov
Keyword(s):  
Spinal Cord ◽  
Vagus Nerve ◽  
Medulla Oblongata ◽  
Artificial Respiration ◽  
Cranial Nerves ◽  
Nerve Trunk ◽  
Accessory Nerve ◽  
Common Trunk ◽  
First Case ◽  
The Common

Starting at the end of the 16th century (Volcherus Goiter - 1573) and up to our time, about sixty authors studied the accessory nerve, partly dedicating special work to it, partly giving their views on the course and ending of this nerve in the textbooks of anatomy and histology published by them. Such persistence in the study of the accessory nerve is explained by the duality of its central beginnings and endings, that is, its origin both from the oblong and from the spinal cord. Already with a rough anatomical examination, it is clear that part of the roots emerging from the lower part of the medulla oblongata, not reaching the foramen jugulare of the skull, joins the nerve trunk, which runs along the lateral surface of the spinal cord and is formed by the connection of the roots emerging from the lateral brain. This common nerve trunk, emerging from the cranial cavity through the foram. jugulare and consisting of N. accessorius vagi and N. accessorius spinalis, received the name N. accessorius Willissi, named after Thomasa Willisa (1682) who described it. After exiting the foramen jugulare, the nerve gives a thin v-point (ramus internus according to Heihendainy) to the plexus ganglioformis n. vagi, and another, thick branch, is sent to the muscles (m. sternocleido-mastoideus). Thus, without the help of a microscope, a close connection between the XI and X pairs of cranial nerves is visible. To this, it must be added that the roots of the XI nerve, emerging from the lower sections of the medulla oblongata, produce the impression of the lower roots of the X nerve, and only their entry into the common trunk of the accessory nerve forces them to be referred to it. Heidenhain, using a physiological method, proved the connection between the accessory nerve and the vagus: he pulled out the accessory nerve in rabbits on the neck and after a few days after the operation did not receive the usual slowing of heartbeats with irritation of the vagus nerve; From this, the author concludes that the retarding heartbeat fibers of the vagus nerve receive an additional one through the ramus internus. Further, the author comes to the conclusion that the fibers of the accessory nerve, which delay the heartbeat, originate from the medulla oblongata. To confirm this view, Heidenhain cites experiments in which he, during artificial respiration of an animal, provided a cut of the medulla oblongata at the apex of the pen (calamus scriptorius) and below; with a slowdown of artificial respiration in the first case, a slowdown of the heartbeat was obtained, and in the second it did not work. Finally, in rabbits, after the accessory nerve was torn out, the laryngeal paralysis was as clearly expressed as after the X nerve was cut; food got into the respiratory tract, and the animals died from pneumonia, which usually began with the upper lobes).

scholarly journals On intracerebral endings and connections of the seventh and eighth pairs of cranial nerves

2020 ◽  
Vol VIII (3) ◽  
pp. 1-15
Author(s):  
N. A. Vyrubov
Keyword(s):  
Facial Nerve ◽  
Medulla Oblongata ◽  
Cranial Nerves ◽  
Auditory Nerves

The anatomy of the facial and auditory nerves, thanks to a whole series of studies produced according to all sorts of methods, seems at the present time very thoroughly developed; but while the method of degeneration (with peripheral lesions) has already understood many connections of the facial nerve in a person, it has not yet been possible to observe sufficiently extensive degenerations in the medulla oblongata and tubercles of the quadruple due to damage to the peripheral auditory canals. It is in this last relationship that the case I have studied is of interest, although it should be noted that for the anatomy of the facial nerve, he also understood some still unknown relationship.

Rehabilitation for Dysphagia Paralytica

1972 ◽  
Vol 37 (2) ◽  
pp. 187-194 ◽  
Author(s):  
George L. Larsen
Keyword(s):  
Brain Stem ◽  
Medulla Oblongata ◽  
Cranial Nerves ◽  
Management Technique ◽  
Rehabilitation Team ◽  
Careful Assessment

Dysphagia paralytica is a disorder of swallowing resulting from a lesion of the cranial nerves or brain stem, in particular the medulla oblongata. Rehabilitation of this disorder depends on careful assessment of spared and damaged processes responsible for swallowing. The management technique is maximum use of assets, capitalizing on intelligence to support reflex bahavior. The various roles of the rehabilitation team are described.

Human Neurofibromas in Co-Culture with Mouse Neurons

1982 ◽  
Vol 40 ◽  
pp. 194-195
Author(s):  
R.L. Martuza ◽  
T. Liszczak ◽  
A. Okun ◽  
T-Y Wang
Keyword(s):  
Schwann Cell ◽  
Schwann Cells ◽  
Genetic Disorder ◽  
Cranial Nerves ◽  
Sympathetic Nerves ◽  
Acoustic Neuromas ◽  
Spinal Roots ◽  
Neural Crest Origin ◽  
Multiple Abnormalities ◽  
Other Neoplasms

Neurofibromatosis (NF) is an autosomal dominant genetic disorder with a prevalence of 1/3,000 births. The NF mutation causes multiple abnormalities of various cells of neural crest origin. Schwann cell tumors (neurofibromas, acoustic neuromas) are the most common feature of neurofibromatosis although meningiomas, gliomas, and other neoplasms may be seen. The schwann cell tumors commonly develop from the schwann cells associated with sensory or sympathetic nerves or their ganglia. Schwann cell tumors on ventral spinal roots or motor cranial nerves are much less common. Since the sensory neuron membrane is known to contain a mitogenic factor for schwann cells, we have postulated that neurofibromatosis may be due to an abnormal interaction between the nerve and the schwann cell and that this interaction may be hormonally modulated. To test this possibility a system has been developed in which an enriched schwannoma cell culture can be obtained and co-cultured with pure neurons.

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