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 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.

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 Autonomic dysreflexia associated with cervical spinal cord gliofibroma: case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroyuki Mizuno ◽  
Fumiaki Honda ◽  
Hayato Ikota ◽  
Yuhei Yoshimoto
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Spinal Cord Tumor ◽  
Autonomic Dysreflexia ◽  
Tumor Biopsy ◽  
Intramedullary Lesion ◽  
First Case ◽  
Cord Injury ◽  
Paroxysmal Hypertension ◽  
Upper And Lower Extremities

Abstract Background Autonomic dysreflexia (AD) is an abnormal reflex of the autonomic nervous system normally observed in patients with spinal cord injury from the sixth thoracic vertebra and above. AD causes various symptoms including paroxysmal hypertension due to stimulus. Here, we report a case of recurrent AD associated with cervical spinal cord tumor. Case presentation The patient was a 57-year-old man. Magnetic resonance imaging revealed an intramedullary lesion in the C2, C6, and high Th12 levels. During the course of treatment, sudden loss of consciousness occurred together with abnormal paroxysmal hypertension, marked facial sweating, left upward conjugate gaze deviation, ankylosis of both upper and lower extremities, and mydriasis. Seizures repeatedly occurred, with symptoms disappearing after approximately 30 min. AD associated with cervical spinal cord tumor was diagnosed. Histological examination by tumor biopsy confirmed the diagnosis of gliofibroma. Radiotherapy was performed targeting the entire brain and spinal cord. The patient died approximately 3 months after treatment was started. Conclusions AD is rarely associated with spinal cord tumor, and this is the first case associated with cervical spinal cord gliofibroma. AD is important to recognize, since immediate and appropriate response is required.

scholarly journals B.05 Hemi-laryngopharyngeal spasm (HELPS) syndrome: The discovery, cure, and characterization of a new neurological condition

2017 ◽  
Vol 44 (S2) ◽  
pp. S11-S11
Author(s):  
C Honey ◽  
M Morrison
Keyword(s):  
Surgical Care ◽  
Review Of The Literature ◽  
The Past ◽  
First Case ◽  
Patient Reported ◽  
Operative Outcome ◽  
Small Cohort ◽  
The Common ◽  
Similar Motor

Background: We published the world’s first case of hemi-laryngpharyngeal spasm (HELPS) syndrome cured by microvascular decompression (MVD) of the Xth cranial nerve in 2016. We now present a small cohort of patients (n=3) successfully treated with surgery in order to better delineate the common characteristics of this syndrome, diagnostic tests of choice, nuances of their surgical care and outcomes of their treatment. Methods: The history and physical examination of three patients with HELPS syndrome are presented. Pre-operative laryngoscopy, neuroimaging, response to botox and intra-operative videos are detailed. Post-operative outcome and complications are presented. Results: Each patient reported similar motor (choking) and sensory (coughing) features in their history. Episodic choking relentlessly progressed over the years until it occurred while sleeping and with frightening severity prompting tracheostomy in one patient and intubation in another. A “tickling” sensation deep in the throat triggered episodic coughing that worsened over the years until it occurred while sleeping and with frightening severity (syncope and incontinence). Conclusions: A review of the literature suggests that patients with similar symptoms, often called episodic laryngospasm in the past, have been treated with psychotherapy or antacids. With the recognition that a clearly defined subset of these patients have HELPS syndrome, we can offer them the potential of a neurosurgical cure.

Facial Ganglia - Anatomy, Symptomatology of Lesions and Biological Relevance

2021 ◽  
Vol 53 ◽  
pp. 41-50
Author(s):  
Ilya Lebedev ◽  
Alexander Bragin ◽  
Yulia Boldyreva ◽  
Artem Borsukov ◽  
Alexander Tersenov ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Facial Pain ◽  
Multidisciplinary Approach ◽  
Human Life ◽  
Cranial Nerves ◽  
Living Organism ◽  
Sympathetic Ganglia ◽  
Historical Background ◽  
Brain And Spinal Cord ◽  
The Brain

The article summarizes information about the head ganglia (the sympathetic ganglia and in the sensory cranial nerves). Gives а brief historical background on the history issue and relevance of the topic. Characterized by each node with its topography and lesion clinic. The described process of treatment, and prospects for new therapies. Raised the issue of the significance of the defeat ganglia, namely, the suffering of the sick and forced treatment costs (due to the complex differential diagnosis). In a biological sense, pain first appears in chordates and during evolution, as well as transformations of the brain and spinal cord, it acquires new types, localization and significance for the performance of a living organism. And facial pain, being a nosology with a multidisciplinary approach in diagnosis and treatment, demonstrates both its complexity and importance in human life.

INCIDENCE OF CRANIAL NERVE PARALYSIS IN POLIOMYELITIS IN RELATION TO PRESENCE OR ABSENCE OF TONSILS

PEDIATRICS ◽  
1958 ◽  
Vol 21 (1) ◽  
pp. 94-105
Author(s):  
F. H. Top
Keyword(s):  
Facial Nerve ◽  
Cranial Nerves ◽  
Age Group ◽  
Real Difference ◽  
Satisfactory Explanation ◽  
Nerve Paralysis ◽  
Cranial Nerve Paralysis ◽  
Significant Difference ◽  
The Central Nervous System ◽  
The Common

Evidence is presented from data covering the period 1940 to 1952 which corroborates the conclusion of previous studies that prior tonsillectomy probably adversely affects the occurrence of brainstem paralysis (bulbar and bulbospinal) in poliomyelitis. Neither this study nor any preceding studies relating to this problem have proved the contention. On the basis that the hypothesis is correct, an attempt is made to find an answer by studying the incidence of the common paralysis of cranial nerves (VII, IX and X and XI) in bulbar and bulbospinal cases of poliomyelitis on the basis of presence or absence of tonsils. Rates of incidence of paralysis of cranial nerves, not adjusted for age, indicate a decidedly higher proportion of paralysis of the facial nerve (VII) among nontonsillectomized patients whereas tonsillectomized persons are preportionately more affected by palatal and pharyngeal paralysis (nerves IX and X). Paralysis of the facial nerve appears from two studies to occur more commonly at earlier ages, particularly in the age group 0 to 4 years. However, age adjustment did not erase, although it did somewhat lower, the TR/TP ratio. This finding lends credence to a real difference but can only be applied to this study, as Paffenbarger in a smaller study found no significant difference in frequencies of paralysis of the facial nerve between groups with tonsils removed and tonsils present, and Southcott, also in a small study, found paralysis of the facial nerve more common among tonsillectomized patients with bulbar (includes bulbospinal) involvement. The differences noted for palatal and pharyngeal paralyses (nerves IX and X) in the unadjusted rates as between tonsillectomized and nontonsillectomized patients remain statistically different and in some instances significant when corrections for age are made. The results of this study are suggestive but give no entirely satisfactory explanation for the differences noted. Various explanations previously offered are cited and briefly discussed. Perhaps more definitive studies in animals along the approach suggested by Southcott will prove more fruitful, namely, labelling virus by some radioactive element in order to trace the route it takes to the central nervous system.

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