[Validation of the French version of the 10-item Big Five Inventory]. / Validation française du Big Five Inventory à 10 items (BFI-10).

OBJECTIVE: Our primary objective was to validate the French version of the BFI-10, an ultra-short ten-item version of the Big Five Inventory (BFI; John et al., 1991), which allows for a reasonably accurate assessment of personality in circumstances in which more in-depth assessment is not possible. In order to reach a thorough evaluation of the external validity, we also aimed to examine the bandwidth of the BFI-10 scales with reference to the study by De Young, Quilty and Peterson (2007) who distinguished between two aspects in each of the Big Five: Assertiveness and Enthusiasm for Extraversion; Compassion and Politeness for Agreeability; Orderliness and Productiveness for Conscientiousness; Withdrawal and Volatility for Negative Emotionality, and finally Openness to Aesthetics and Openness to Ideas for Open-Mindedness. Our concern with regard to bandwidth was to examine whether the BFI-10 scales have strong enough correlations with both aspects of each domain. METHODS: Participants. Data from four samples were analysed: Sample 1 comprised 2499 undergraduate students (1654 women) who completed the full BFI in university classes; Sample 2 comprised 13,306 participants (8471 women) who filled out the BFI-10 ten items online via Internet; Sample 3 comprised 143 undergraduate students (115 women) who completed the full BFI twice with a two-week interval; Sample 4 comprised 360 undergraduate students (183 women) who filled out the BFI and NEO PI-R. INSTRUMENTS: The French version of the Big Five Inventory is a 45-item inventory, which measures the five broader domains of personality. The ultrashort Ten-item Big Five Inventory (BFI-10) was developed simultaneously in German and English by Rammstedt and John (2007); it comprises five two-item scales measuring the big five domains. The Neuroticism-Extraversion-Openness Personality Inventory Revised (NEO PI-R; Costa et McCrae, 1992) is a 240-item questionnaire which assesses the big five domains and 30 lower-order facets, i.e. six facets per domain. STATISTICAL ANALYSES: Factor structure and reliability of the five two-item scales were first investigated on samples 1 and 3. Confirmatory factor analyses (CFAs) were conducted on samples 1 and 2, and discriminant validity was assessed via comparison with the NEO PI-R (sample 4). In order to examine the bandwidth of the BFI-10 two-item scales, we studied their correlation not only with the NEO PI-R domains but also with the 30 facets. RESULTS: The CFAs showed the good fit of the five-factor structure, with RMSEA=.077 (.072), CFI=.974 (.956), and SRMR=.029 (.027) in samples 1 and 2 respectively. Multigroup CFA conducted in groups 1 and 2 showed invariance across gender of factor loadings and item intercepts. Test-retest reliability was satisfactory with rs ranging from .68 (Open-Mindedness) to .86 (Extraversion and Negative Emotionality). The comparison of the two-item scales with the NEO PI-R scales showed high correlations not only with the NEO domain scales, but also with several facets: Four BFI-10 two-item scales (Extraversion, Conscientiousness, Negative Emotionality, and Open-Mindedness) were highly correlated with at least three of the six NEO facet scales in each domain. For Agreeableness, the magnitude of correlations was smaller, but the pattern of correlations was the same. All BFI-10 scales had at least moderate correlations with both aspects of each domain, with the exception of Negative Emotionality, which measured the NEO Withdrawal aspect better than Volatility. CONCLUSION: The French version of the BFI-10 demonstrated the expected five-factor structure, satisfactory reliability, and broad bandwidth. It could be a valuable tool for the assessment of personality in circumstances in which it is not possible to use a longer and more in-depth instrument, especially when personality is not the main focus of research but one of the variables to be controlled.

[Does the French Big Five Inventory evaluate facets other than the Big Five factors?] / Le Big Five Inventory français permet-il d'évaluer des facettes en plus des cinq grands facteurs ?

INTRODUCTION: The Big Five Inventory (BFI) developed by John et al. (1991) is one of the most widely accepted tools for assessing dimensions of personality. It comprises 44 items that assess five broad dimensions of personality (the Big Five Factors): Extraversion, Agreeableness, Conscientiousness, Neuroticism and Openness to experience. Based on correlations with the facets described in the NEO Personality Inventory Revised (NEO PI-R), another Big Five assessment tool with 240 items and 6 facets per dimension, Soto and John (2009) showed that the dimensions in the BFI could be divided into two facets each (ten facets altogether). These results are in line with those of DeYoung et al. (2007), who ran factorial analyses with all the NEO PI-R facets and the International Personality Item Pool (IPIP) and identified ten intermediate factors (between facets and dimensions) which they called "aspects" (two per dimension). The goal of the present study is to investigate the ten facets described by Soto and John in a French sample, using the French version of the BFI (BFI-Fr), which has good psychometric properties, and to check whether the pattern of correlations of these facets with the NEO PI-R match those of the American version. METHOD: We created three groups. The first comprised 360 students from the Institut libre d'éducation physique supérieure (ILEPS) and Tours University (psychology undergraduates). Participants (mean age 21.1 years±2.30; 58% women) completed the BFI-Fr and the NEO PI-R. The second comprised 142 psychology students from Tours University (mean age 20.6 years±1.78; 81% women); they completed the BFI-Fr twice, two weeks apart (test and retest). The third comprised 252 psychology students from Paris-Nanterre University (mean age 23 years±4.2; 89% women) who described a total of 405 people they knew well (mean age 35.2±10.8; 49% women) using the peer-report format of the BFI-Fr. RESULTS: In the self-report format, eight of Soto and John's ten aspects had acceptable internal consistency (based on Guildford's (1954) internal consistency criteria, due to the small number of items), with Cronbach's α between 0.60 and 0.86 and test-retest correlations between 0.71 and 0.89, showing satisfactory temporal stability. We found a single facet for Extraversion (Assertiveness), two for Agreeableness (Altruism and Compliance), two for Conscientiousness (Self-Discipline and Order), one for Neuroticism (Anxiety), and two for Openness to Experience (Openness to aesthetics and Openness to ideas). Based on their convergence with the corresponding facets in the NEO PI-R, these eight facets showed satisfactory external validity. With regard to the peer-report format, the Activity facet of Extraversion, which did not have sufficient internal consistency in the self-report format, had acceptable properties (i.e. 9 out of 10 facets). Only the Depression facet of Neuroticism still had insufficient internal consistency. In this study, we proposed an improvement of two facets (Activity and Compliance) and added one facet specific to the French version (Emotional Instability) in place of the Depression facet. DISCUSSION: We showed that the BFI-Fr can be used to assess nine of the ten facets described by Soto and John. We also identified an Emotional Instability facet, replacing the Depression facet of Neuroticism. DeYoung et al. (2007) considered that anxiety and depression are indissociable and can be represented by a Neuroticism aspect they labeled Withdrawal. They suggested a second aspect of this dimension they called Volatility (with the N2 Angry Hostility facet of the NEO PI-R as main marker and the N5 Impulsiveness and N3 Depression as secondary markers). The Emotional Instability facet we found corresponds closely to the N2 Angry Hostility facet of the NEO PI-R and appears to be a satisfactory marker of DeYoung et al.'s (2007) Volatility aspect. Although this study has limitations, particularly related to the samples (students), the BFI-Fr facets (derived from those defined by Soto and John in the BFI or proposed as improvements on the original facets) match the corresponding NEO PI-R facets and can also be seen as main markers of the aspects defined by DeYoung et al.

From Phineas Gage and Monsieur Leborgne to H.M.: Revisiting Disconnection Syndromes.

On the 50th anniversary of Norman Geschwind's seminal paper entitled 'Disconnexion syndrome in animal and man', we pay tribute to his ideas by applying contemporary tractography methods to understand white matter disconnection in 3 classic cases that made history in behavioral neurology. We first documented the locus and extent of the brain lesion from the computerized tomography of Phineas Gage's skull and the magnetic resonance images of Louis Victor Leborgne's brain, Broca's first patient, and Henry Gustave Molaison. We then applied the reconstructed lesions to an atlas of white matter connections obtained from diffusion tractography of 129 healthy adults. Our results showed that in all 3 patients, disruption extended to connections projecting to areas distant from the lesion. We confirmed that the damaged tracts link areas that in contemporary neuroscience are considered functionally engaged for tasks related to emotion and decision-making (Gage), language production (Leborgne), and declarative memory (Molaison). Our findings suggest that even historic cases should be reappraised within a disconnection framework whose principles were plainly established by the associationist schools in the last 2 centuries.

Exploratory study toward development of the French version of the questionnaire on personality traits (QPT/VKP-4) in an elderly population in comparison to young adults.

This research is an exploratory study toward development of the French version of the Questionnaire on Personality Traits (QPT/VKP-4). The goal was to assess its association with the Big Five Inventory (BIG-5) and to explore the personality characteristics of the elderly compared to young adults. The 241 participants included 83 elderly people and 158 young adults. Borderline and anxious personality disorders were less frequent in elderly women than in young women, and depressive personality disorder was less frequent in elderly men. Dimension scores were higher for Conscientiousness in the elderly, Agreeableness in elderly women, and Extraversion in elderly men. Statistically significant correlations were found between personality dimension scores using the VKP-4 and the BIG-5.

Paul Broca's historic cases: high resolution MR imaging of the brains of Leborgne and Lelong.

In 1861, the French surgeon, Pierre Paul Broca, described two patients who had lost the ability to speak after injury to the posterior inferior frontal gyrus of the brain. Since that time, an infinite number of clinical and functional imaging studies have relied on this brain-behaviour relationship as their anchor for the localization of speech functions. Clinical studies of Broca's aphasia often assume that the deficits in these patients are due entirely to dysfunction in Broca's area, thereby attributing all aspects of the disorder to this one brain region. Moreover, functional imaging studies often rely on activation in Broca's area as verification that tasks have successfully tapped speech centres. Despite these strong assumptions, the range of locations ascribed to Broca's area varies broadly across studies. In addition, recent findings with language-impaired patients have suggested that other regions also play a role in speech production, some of which are medial to the area originally described by Broca on the lateral surface of the brain. Given the historical significance of Broca's original patients and the increasing reliance on Broca's area as a major speech centre, we thought it important to re-inspect these brains to determine the precise location of their lesions as well as other possible areas of damage. Here we describe the results of high resolution magnetic resonance imaging of the preserved brains of Broca's two historic patients. We found that both patients' lesions extended significantly into medial regions of the brain, in addition to the surface lesions observed by Broca. Results also indicate inconsistencies between the area originally identified by Broca and what is now called Broca's area, a finding with significant ramifications for both lesion and functional neuroimaging studies of this well-known brain area.

Anatomical and radiological evidence for the iliolumbar vein as an inferior lumbar venous system.

The purpose of this work was to study an inferior lumbar venous system, which turned out to be the vertical component of the iliolumbar vein as defined in early works by Bourgery and Jacob, though there is a terminological ambiguity between the iliolumbar vein and the ascending lumbar vein in the literature. However, the iliolumbar vein is most commonly defined as a vein draining the fourth and fifth lumbar vertebral segments. Cadaver studies, including one injection-corrosion, and in vivo venograms were analyzed by visual inspection and measurements. Whether the injection was made via the axillary or the saphenous veins, the inferior lumbar vein was always filled, demonstrating that it is part of the vertebral venous system. An interruption or a plexiform shape of the venous system at the level of the third lumbar vertebra, and an increase in caliber as this vein runs downwards, allowed differentiating the inferior lumbar vein from the ascending lumbar vein. The inferior lumbar vein and the superior iliac vein drained into the iliac veins, either external or internal iliac vein, but typically into the common iliac vein, separately or with a single common trunk. This common trunk was observed in 92% of the dissected cases on the right side and in 46% on the left, whereas it was seen in 50% of the radiological studies on the right side and 52% on the left. Consequently, the inferior lumbar vein was the main component of the iliolumbar vein, and as such should be differentiated from the ascending lumbar vein.

Perception of medical students towards the clinical relevance of anatomy.

Recent developments worldwide in medical curricula have often led to major cuts in the teaching of human anatomy. Indeed, it is perceived by some that gross (topographical) anatomy has an exaggerated importance in the initial training of doctors. The value of anatomy consequently has frequently been considerably diminished within medical curricula that have reduced factual content. To date, however, there have been no objective studies into the perceived relevance of anatomy to clinical medicine that have aimed to quantify the attitudes of medical students. On the basis of responses to an attitude analysis questionnaire devised according to the precepts of Thurstone and Chave (The Measurement of Attitude: A Psychophysical Method and Some Experiments with a Scale for Measuring Attitude Toward the Church. Chicago, IL: University of Chicago Press, 1951), we investigated the perception of medical students at Cardiff and Paris towards the importance of gross anatomy to clinical medicine. This was undertaken during the early stages of their studies (when they were newly-admitted to university and were about to commence anatomy courses), immediately after finishing their anatomy courses, and later in the final year of medical studies. The results suggest that, even where there might be geopolitical and cultural backgrounds, students at all stages of their medical course share with professional anatomists the view that anatomy is a very important subject for their clinical studies. Thus, contrary to the unquantified beliefs of those who are sceptical about the purpose and value of anatomy in an undergraduate medical curriculum, the students themselves do not appear to share such beliefs.

[3D modeling in the field of morphology: methods, interest and results]. / La modelisation tridimensionnelle en morphologie: méthodes, intérêt et résultats.

The aim of this paper is to show the major role played by the new computerized imaging tools available today in the fields of morphology and anatomy. For anatomical studies or educational purpose, they enhance the classical techniques. The 3D reconstruction, already used in daily clinical practice, will be the basis for computation of validated volumetric protocols enhancing our diagnosis and prognosis means. It is also a fantastic educational tool: the interactivity makes it simple, efficient, attractive and easily accessible and diffusable. For the research, mathematical modeling of embryogenesis and morphogenesis using finite elements method will open new ways for biomecanics and a dynamic quantification approach.

[3D reconstruction of anterior internal vertebral venous plexus of a human fetus: a feasibility study]. / Reconstruction tridimensionnelle des plexus veineux vertébraux internes et antérieurs d'un foetus humain: étude de faisabilité.

Anterior internal vertebral venous plexus have been studied extensively due to their clinical importance in diseases of the spine and obstruction of the inferior vena cava. The aim of this feasibility study was to reconstruct in 3D the lower thoracic area of the anterior epidural space of a 69 mm (crown-rump) human fetus from the Rouvière Collection, circa 1927. Forty slices (spaced by 40 microm) at the level of the tenth and eleventh thoracic vertebrae, and their lower adjacent intervertebral discs, were reconstructed in 3D using the commercial software SURFdriver. In a preliminary study, we had found that the structures of the epidural space are already formed at this stage of development, and that they are comparable to the adult stage (2002). Reconstruction of the microscopic slices in 3D allowed to better visualize spatially the structures of the venous plexus and their anatomical relationships. This technique could be used as a complement to the classically used histological studies.

Going back to dissection in a medical curriculum: the paradigm of Necker-Enfants Malades.

In 1999, we first reported on various methods of teaching anatomy subsequent to visits to a variety of medical schools in the United States and Europe. We compared the number of contact hours for lectures, dissection classes and tutorials and provided different models for the teaching of anatomy. With respect to the nine French medical schools surveyed, it is clear that the French model is characterized by being lecture-orientated (time in lectures > time in tutorials > time spent on dissection). For the American model (also in the UK and some other parts of Europe), the training is often characterized by being dissection-based (time spent on dissection > time in lectures > time in tutorials; 10 medical schools surveyed). Exceptionally, in one Australian school, time in tutorials exceeds time in lectures (dissection = 0). The differences between the French and American models relate to teaching aims-where dissection predominates, the aims are not just the learning of anatomical facts but include practical skill acquisition and experiential learning. In 2001, to help us change the methods of teaching of anatomy in our medical school at CHU Necker-Enfants Malades (Paris V, France), we asked other French medical schools (and some foreign schools) to suggest ways of organizing anatomy training within certain time constraints. In this paper, we present the answers received. The responses received were of two kinds: (1) those providing a description of the anatomy teaching in their own medical school; (2) those providing a system for organizing the teaching if we, in Paris, have 120 hours in total to teach gross anatomy (except neuroanatomy). In the latter case, a considerable variety of different, and innovative, alternative schemes were suggested that are described in this article.

Morphometry by computerized three-dimensional reconstruction of the hypogastric plexus of a human fetus.

The histological study of the plexus hypogastricus inferior (hypogastric plexus) of a human fetus does not permit the direct appreciation of its spatial configuration and its complicated relations. Developments in the field of computer science and three-dimensional (3D) reconstruction from serial histological sections have allowed a precise description of its morphometry and relations. The histological sections which were used came from the "Rouvière" collection of the Institute of Anatomy in Paris. A personal computer (IMAC) system of image analysis with reconstruction software was used. Serial pelvic histological sections were directly digitized from the slides. Image treatment and reconstruction were done with manual methods. The 3D reconstruction of the hypogastric plexus, the nerves, the pelvic skeleton and viscera were done. The hypogastric plexus and its topographic relations with the other organs were visualized and studied in three dimensions, and its morphometry was studied. The direct acquisition of the images from the slides allowed excellent high-quality digital images to be obtained. However, manual processing for the reconstruction was time-consuming. At first, the reconstruction of the various pelvic structures was done separately for each organ. Then the structures were visualized all together. Thus, the hypogastric plexus could be examined under various incidences with each organ. The virtual images obtained show new details of the topographic relations and improve knowledge of the precise innervation of the pelvic organs.

The human lumbar anterior epidural space: morphological comparison in adult and fetal specimens.

To increase our understanding of the clinical anatomy of the epidural space, the human lumbar anterior epidural space was studied morphologically and developmentally. Histological transverse sections of human lumbar spines were taken at the level of the intervertebral disc and the vertebral body in adult specimens and in fetuses aged 13, 15, 21, 32 and 39 weeks (menstrual age). At 13 weeks, connective tissue filled the epidural space. The dura mater was attached anteriorly to the posterior longitudinal ligament (PLL). The PLL was attached to the vertebral body beside the midline, whereas it adhered to the posterior edge of intervertebral disc. The anterior internal vertebral venous plexus was located anterolaterally and anteromedially. The vertebral canal was lined with connective tissue that differentiated in a periosteum in contact with the ossification centers. At 15 weeks, the PLL was composed of deep and superficial layers. At 21 weeks, the attachment between the dura mater and PLL was ligament-like at the level of the vertebral body. At 32 weeks, the dura mater was adherent to the superficial layer of PLL. At 39 weeks, groups of adipocytes were identified, and the dura mater was attached to the PLL by some ligaments. There were many more similarities between the adult and the 39-week fetus. In conclusion, some differences in the anatomy of the epidural space exist at each fetal stage studied. The structures of the epidural space are already formed in the fetus of 13 weeks, but they differentiate progressively within the connective tissue.

[Microscopic vascular study of the colon with the corrosion casting technique]. / Etude vasculaire microscopique du colon par la technique d'injection-corrosion.

The aim of this study is, firstly, to assess the accuracy of vascular casts obtained at various times after death and secondly to describe the mucosal microvascular architecture of the cat colon. Two injections were realized, the first one on a non-embalmed human corpse, 12 days after the death, and the other one on a cat, immediately following euthanasia. Results show that this second cast seems finer and more detailed than the cast stemming from the human corpse; indeed, the finest vessels obtained are about 6 microns while they are about 15 microns on the human corpse. This could be explained by a post-mortem obstruction of microvessels, that prevented the passage of the injected product or by an insufficient amount of product injected. Finally, the vascular cast of the cat colic mucosa presents a regular honeycomb-like network that bounds the colonic mucosal glands, a finding consistent with the results reported previously.

The origin of the azygos venous system, as deduced from an anatomical and radiological study employing a corrosion technique.

The aim of this study is not only to describe the origin of the human azygos venous system by performing a 3-D reconstruction of a CT scan but also to evaluate the value of the techniques employed in investigating the topographical anatomy of a venous system in the body. Following perfusion with saline to wash away the blood, we injected an ALTUFIX/MINIUM mixture into the azygos vein of a cadaver. The head and trunk were subsequently corroded with hydrochloric acid (HCl). A CT scan of the trunk was obtained both before and after corrosion. According to the spatial resolution of the CT scan, the thinnest identifiable detail was measurable as 0.5 mm. The vertebral lumbar venous system was described, specifying the nomenclature of the lumbar veins (the lumbar veins being designated according to the vertebral body along which they run). On the right side, the lumbar veins at L2 and at L3 formed the lateral root of the azygos vein. On the left side, the vein at L2 formed the reno-azygo-lumbar arch (of Lejars). The lumbar veins, and the origin of the azygos system, were described and compared with previous studies. The 3-D reconstruction showed the importance of veins associated with the posterior paravertebral muscles. This description poses the problem of the metamerisation of the veins, but further evidence is required. Comparisons of the CT scans, 3-D reconstructions, and the ALTUFIX models of the veins obtained from the corrosion technique allowed verification of the 3-D reconstruction and correction of the errors inherent in a computer reconstruction. It is concluded that the description, and understanding, of such a complex system as the vertebral venous system is more valid when the results obtained using different techniques are compared.

[The lumbar vein at L2 and the reno-azygo-lumbar arch: anatomic and radiologic studies]. / La veine lombaire en L2 et l'arc réno-azygo-lombaire: étude anatomique et radiologique.

The lumbar vein at L2 was described by C. Gillot and B. Singer (1974). On the right side, after drawing off the 12th intercostal vein, it forms the lateral root of the azygos vein. Its way is as a frame, transverse going along the body of the 2nd lumbar vertebra, then upward along the spine after having integrated the veins of the L2-L3 intervertebral foramen. In its typical form, the vein is at L2 but it can be at L1 or L3. It takes the name of lateral root of the azygos vein only after receiving the 12th intercostal vein. Because of its diameter (5 mm), it forms a cavo-caval anastomosis via the azygos vein. The renal azygo-lumbar arch of Lejars is the equivalent on the left side of the right vein at L2. This arch contributes to the formation of the lateral root of the hemi-azygos vein. The right vein at L2 and the reno-azygo-lumbar arch were studied by dissections and by radiologic protocols. The radiologic studies (CT, MRI, 3D reconstructions) were carried out after injections of gelatin-gadolinium-minimum and altufix-minimum mixtures. The results showed the numerous variations of origin of the azygos system. The use of multiple and complementary technics are very helpful to describe these variations.

Technique for injection of the lumbar vertebral venous plexuses employed in anatomic, computed tomography and magnetic resonance imaging studies.

The aim of this study was to develop a technique for injection of the vertebral venous plexuses allowing anatomic, computed tomography (CT) and magnetic resonance imaging (MRI) studies of the same anatomic specimen. It proved in practice that only a correctly adjusted mixture of different agents allowed attainment of this objective. This mixture, composed of gelatin, gadolinium and minium, enabled us to attain this end. The description of the technique of injecting the vertebral venous plexuses, the difficulties encountered and the results of the different imaging techniques are analysed in this study without entering into details of the anatomic description. The core of the study consists of 11 unembalmed subjects. Three were injected with gelatin mixed with gadolinium, one with latex mixed with minium, one with latex mixed with gadolinium, and 6 with gelatin mixed with both gadolinium and minium. Only the mixture of gelatin-gadolinium-minium allowed study of the same anatomic specimen in terms of anatomy, CT and MRI. Two different MRI sequences are described, evidence of the different properties of the injection mixture (gelatin, gadolinium). The latex-minium mixture gave good CT density but was unsuitable for MRI studies. Numerous artifacts caused interference with the radiologic images, calling for perfect injection technique. The use of several radiologic techniques for a single cadaveric injection allows better correlation of the images, and comparison and verification of results between the techniques.

Functional Neuroimaging of Cortical Dysfunction in Alcoholic Korsakoff's Syndrome.

Many neuropsychological investigations of human memory have focused on the amnesic deficits of alcoholic Korsakoff's syndrome. Structural neuroimaging suggests that the syndrome results from midline diencephalic damage, but functional neuroimaging has the potential to reveal additional neuropathology that may be responsible for cognitive dysfunction. Accordingly, high-resolution positron emission tomography (PET) was used to measure regional cerebral metabolic rates for glucose utilization in five alcoholic Korsakoff patients and nine alcoholic control subjects. Results from a continuous recognition test administered during the radiotracer uptake period indicated that all subjects performed normally with respect to immediate memory, whereas Korsakoff patients demonstrated a marked memory impairment in delayed recognition. PET results from the Korsakoff group showed a widespread decline in glucose metabolism in frontal, parietal, and cingulate regions, suggesting that these functional abnormalities in the cerebral cortex contribute to the memory impairment. Hippocampal glucose metabolism did not differ between the groups. Thus, the evidence did not support the hypothesis that parallel brain dysfunctions are responsible for the similar amnesic symptomatology after hippocampal and diencephalic damage. We hypothesize that the amnesic dysfunction of Korsakoff's syndrome depends on a disruption of thalamocortical interactions that mediate a function critical for normal memory storage.

The lumbar anterior epidural cavity: the posterior longitudinal ligament, the anterior ligaments of the dura mater and the anterior internal vertebral venous plexus.

The contents of the anterior epidural cavity were studied to elucidate the relationship between veins, ligaments, and membranous formations. Anatomical, radiological and histological studies on human specimens after latex or gelatin/gadolinium venous injection at the level of the lumbar spine show that the posterior longitudinal ligament is a cross-shaped formation which includes the septum, the superficial part extending into the intervertebral foramen and the anterior ligaments of the dura mater. The anterior epidural cavity contains two medial and two lateral spaces. The two medial cavities enclose anterior and medial venous plexuses, which together receive the basivertebral veins; the two lateral cavities receive the anterior longitudinal veins. Contents of the medial and lateral cavities pass freely between the two. The lateral cavity connects with the intervertebral canal and dorsally into the posterior epidural space.

MRI of the epidural space after gelatin/gadolinium venous injection.

The head and vertebral column from two human cadavers were injected with a solution of gelatin and gadolinium (Dotarem) and imaged using magnetic resonance imaging (MRI). Comparisons between gross anatomic slices and corresponding images of the lumbar vertebral column confirmed the usefulness of a paramagnetic agent for visualising the epidural venous plexus. This technique provides accurate images of the posterior longitudinal ligament.