Simultaneous lateral and posterior ponticles resulting in the formation of a vertebral artery tunnel of the atlas: case report and review of the literature

The foramen arcuale is infrequently found and is potentially a clinically/surgically significant anatomical variation of the atlas. When present, the vertebral artery travels through this bony ring after exiting the transverse foramen of the atlas and prior to entering the cranium. We present a case of an adult female skeleton noted to harbor both a foramen arcuale and a lateral ponticle that resulted in the formation of a canal for the vertebral artery. The literature regarding these osteological structures is reviewed regarding their presence and potential clinical significance. The simultaneous occurrence of fully developed lateral and posterior ponticuli resulting in encasement of the third part (atlantal segment) of the vertebral artery appears to be very rare. Based on the literature regarding only foramina arcuale and their presence predisposing one to symptomatic entrapment, additional compression, as seen in our specimen, of the vertebral artery by a lateral ponticle could very likely result in stenosis of the vertebral artery.     

Ruggero Ferdinando Antonio Guiseppe Vincenzo Oddi

Long forgotten in his motherland but for a single discovery—a small circular tissue whose workings are as mysterious as its discoverer—a brilliant anatomist and physiologist, Oddi, gained his fame at the age of 23 years with his identification of the sphincter that would later be named in his honor. In 1984 Ruggero Oddi, was celebrated and revered in his native town of Perugia with a monument. Ruggero Oddi lived a tumultuous life, full of grief and tragedy, only to culminate in a lonely death while exiled in a foreign land. We now review the life of this contributor to modern anatomy.     

Jacob B. Winslow (1669-1760)

Jacob Winslow was a Dutch born, French naturalized anatomist and physician whose contributions to medicine are abundant. His importance to medicine is undisputed. His personal life included a religious crisis that resulted in his estrangement from his family, but afforded him patrons in Paris to continue his work. Following this conversion, he changed his name to that of his catechist and was rechristened Jacques Benigne Wilson. His respect as an expert was well deserved, and he held several prominent positions during his career in Paris. His main work, Exposition anatomique de la structure du corps humain, was published in 1732 and is considered the first purely anatomical treatise. This review highlights his contributions to anatomy and medicine through the course of his career.     

Nerve root to lumbar disc relationships at the intervertebral foramen from a surgical viewpoint: An anatomical study

The objective of this study was to analyze relationship of the intervertebral disc to the nerve root in the intervertebral foramen. Fourteen formalin-fixed cadavers were studied and measurements were performed. At the medial line of the neural foramen, the disc-root distance gradually increased from L1-L2 to L5-S1. The shortest distance between the disc to nerve root was L1-L2 (mean, 8.2 mm) and the greatest distance was found at L3-L4 (mean, 10.5 mm). In the mid-foramen, the disc-root distance decreased from L1-2 to L5-S1. The shortest distance from the disc to nerve root was found at L5-S1 (mean, 0.4 mm); and the greatest distance, at L1-L2 (mean, 3.8 mm). For the lateral line, the distance between an intersection point between the medial edge of the nerve root and the superior edge of the disc and lateral line of the foramen consistently increased from L1-L2 to L5-S1. The shortest distance from nerve root to the lateral border of the foramen, at the point where the nerve root crosses disc was at level L1-L2 (mean, 2.6 mm), the greatest distance, L5-S1 (mean, 8.8 mm). The width of the foramina progressively increased in a craniocaudal direction (mean, 8.3-17.8 mm from L1-2 to L5-S1, respectively). The mean height of the foramina was more or less the same for disc levels (range, 19.3-21.5). The results showed that nerve roots at lower levels traveled closer to the midline of the foramen. This morphometric information may be helpful in minimizing the incidence of injury to the lumbar nerve root during foraminal and extraforaminal approaches.     

Absence of the celiac trunk: case report using MDCT angiography

The authors describe a case of a 57-year-old male patient with peripheral vascular disease which presented on MDCT angiography the absence of the celiac trunk (CT). The left gastric artery (LGA), common hepatic artery (CHA), and splenic artery (SA) (with an internal diameter at origin of 3.3, 6.0, and 6.2 mm, respectively) originated directly and independently from the abdominal aorta (AA). The LGA arose from the anterior wall of the AA [27 mm above the origin of the superior mesenteric artery (SMA)]. The SA and CHA arose from the left side of the anterolateral wall of the AA at 19 and 14 mm (respectively) above the origin of the SMA. The incidence and developmental and clinical significance of this vascular variation are discussed with a detailed review of the literature.     

An aberrant cerebellar artery originating from the internal carotid artery

The aberrant origin of the cerebellar arteries from anterior cerebral circulation is a quite rare vascular variation. Herein, we report a 52-year-old white female with angiographically occult subarachnoid hemorrhage. Left superior and anterior inferior cerebellar arteries were not detected. An aberrant cerebellar artery was noted to arise from the left cavernous internal carotid artery and terminated in the distribution of the ipsilateral superior and anterior inferior cerebellar arteries. This variant artery might likely have resulted from an abnormal regression of fetal anterior-to-posterior circulation connections, and may represent a fetal-type cerebellar artery. A review of the anatomy and clinical significance of the variant is presented.     

A review of supernumerary and absent limbs and digits of the upper limb

For years people have been enamored by anomalies of the human limbs, particularly supernumerary and absent limbs and digits. Historically, there are a number of examples of such anomalies, including royal families of ancient Chaldea, tribes from Arabia, and examples from across nineteenth century Europe. The development of the upper limbs in a growing embryo is still being elucidated with the recent advent of homeobox genes, but researchers agree that upper limbs develop between stages 12–23 through a complex embryological process. Maternal thalidomide intake during limb development is known to cause limb reduction and subsequent amelia or phocomelia. Additionally, a number of clinical reports have illustrated different limb anomaly cases, with each situation unique in phenotype and developmental abnormality. Supernumerary and absent limbs and digits are not unique to humans, and a number of animal cases have also been reported. This review of the literature illustrates the historical, anatomical, and clinical aspects of supernumerary and absent limbs and digits for the upper limb.