The Arterial Anatomy of the Cerebellum-A Comprehensive Review.

The cerebellum, a major feature of the hindbrain, lies posterior to the pons and medulla and inferior to the posterior part of the cerebrum. It lies beneath the tentorium cerebelli in the posterior cranial fossa and consists of two lateral hemispheres connected by the vermis. The cerebellum is primarily supplied by three arteries originating from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior inferior cerebellar artery (AICA), and the posterior inferior cerebellar artery (PICA). However, variations of the cerebellar arteries may occur, such as duplication of the SCA, SCA creating a common trunk with the posterior cerebral artery, triplication of the AICA, and agenesis of PICA, amongst others. Knowledge of the arterial anatomy of the cerebellum is crucial, as inadequate blood supply to this region can result in diminished motor functioning, significantly impacting the quality of life for patients. The present study demonstrated the importance of adequate anatomical knowledge of the arteries supplying the cerebellum. The PubMed and Embase databases were searched to gather articles on the anatomical characteristics and variations of the arterial supply of the cerebellum. It is the most comprehensive and up-to-date review available in the literature. The possible variations of these vessels may be clinically silent or present with clinical symptoms such as neurovascular compression syndromes of the cranial nerves and aneurysms. With a comprehensive understanding of the cerebellar arterial system, physicians can enhance their diagnostic and treatment capabilities, ultimately leading to more effective management of cerebellar vascular-related issues and other neurological deficits.

The complete anatomy of the mandibular lingula: a meta-analysis with clinical implications.

BACKGROUND: The objective of this meta-analysis was to investigate the anatomical variations of the mandibular lingula (ML) and its relationship to surrounding anatomical structures. Understanding such variations is crucial to help determine the site and depth of a successful inferior alveolar nerve (IAN) anesthetic block as well as a safe area for oral and maxillofacial invasive procedures in order to minimize the risk of neurological or hematological damage to the inferior alveolar nerve. MATERIALS AND METHODS: A systematic search was conducted in which all studies were searched on the anatomy of ML. Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library were searched. RESULTS: All of the results were based on a total of 4694 subjects. The overall height of the ML was found to be 8.17 mm (SE =0.22). The Triangular Type of the ML was found to be the most common one. The pooled prevalence of this variation was found to be 29.33% (LCI = 23.57% ; HCI = 35.24%). The pooled prevalence of the Nodular Type was set to be 27.99% (LCI = 22.64% ; HCI = 33.67%). CONCLUSIONS: The present meta-analysis provides clinically relevant information regarding the shape, location, and height variations of the ML. Understanding such variations of the ML is crucial when performing malocclusion corrections procedures that require the ML as a landmark, namely sagittal split ramus osteotomy, and intraoral vertical ramus osteotomy. Furthermore, effective anesthetic blocks during oral and maxillofacial procedures can be accomplished with a higher success rate if the correct site of injection is identified. The possible locations of the ML should be considered in order to determine the location of the mandibular foramen and, therefore, inferior alveolar bundle in order to prevent motor, sensory, or perfusion pathology during maxillofacial and oral procedures of the lower jaw.

The anatomy of the atrioventricular nodal artery: A meta-analysis with implications for cardiothoracic surgery and ablation procedures.

The objective of the present meta-analysis was to evaluate recent and applicable data regarding the location and variation of the atrioventricular nodal artery (AVNA) in relation to adjacent structures. In order to minimize postoperative risks and maintain physiological anastomosis for proper cardiac function, understanding such possible variations of vascularization of the AV node is of immense importance prior to cardiothoracic surgery as well as ablations. In order to perform this meta-analysis, a systematic search was conducted in which all articles regarding, or at least mentioning, the anatomy of the AVNA was searched. In general, the results were based on 3919 patients. AVNA was found to originate only from the RCA in 82.41% (95% CI: 79.46%-85.18%). The pooled prevalence of AVNA originating only from LCA was found to be 15.25% (95% CI: 12.71%-17.97%). The mean length of AVNA was found to be 22.64 mm (SE = 1.60). The mean maximal diameter of AVNA at its origin was found to be 1.40 mm (SE = 0.14). In conclusion, we believe that this is the most accurate and up-to-date study regarding the highly variable anatomy of the AVNA. The AVNA was found to originate most commonly from the RCA (82.41%). Furthermore, the AVNA was found to most commonly have no (52.46%) or only one branch (33.74%). It is hoped that the results of the present meta-analysis will be helpful for physicians performing cardiothoracic or ablation procedures.

The occipital artery: a meta-analysis of its anatomy with clinical correlations.

The occipital artery arises as one of the main branches of the external carotid artery. The goal of the present meta-analysis was to provide a detailed analysis of the complete anatomy of the occipital artery using the available data in the literature. The main online medical databases such as PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar were used to gather all studies on anatomical variations, course, branches, and the close anatomical area of the occipital artery. A total of 65 studies were indicated, evaluated, and included in this meta-analysis. The occipital artery was found to run in the groove with a prevalence of 83.93% (95% confidence intervals: 50.53-100.00%). The occipital artery forming a common trunk with another artery had a prevalence of 13.91% (95% confidence intervals: 9.15-19.47%). The mean maximal diameter of the occipital artery was set to 2.26 mm (standard error = 0.15). The mean maximal diameter of the occipital segment of the occipital artery was found to be 1.24 mm (standard error = 0.15). The mean occipital artery length was set to 131.93 mm (standard error = 3.02). In conclusion, the authors of the present study believe that this is the most accurate and up-to-date meta-analysis regarding the anatomy of the occipital artery. Knowledge about this structure can be of great use when performing revascularization procedures, such as the occipital artery-posterior inferior cerebellar artery bypass, or reconstructive procedures, such as the occipital artery fascial flap.

Bacillary Angiomatosis in Renal Transplant Recipient: A Case Report.

INTRODUCTION: Bacillary angiomatosis (BA) is a rare, opportunistic infectious disease caused by the aerobic Gram-negative bacilli Bartonella henselae or Bartonella quintana. The main reservoir for those microbes are cats. The disease mostly affects immunocompromised patients with human immunodeficiency virus infection, after organ transplantation, undergoing corticosteroid and methotrexate therapy or with oncological history. CASE REPORT: We represent the case of a 65-year-old man who reported to the Department of Dermatology with a high fever and numerous nodular skin lesions on the 5th month of kidney transplantation. At that time, his immunosuppressive therapy consisted of tacrolimus 6 mg/day, mycophenolate mofetil 2 g/day, and prednisone 5 mg/day. Laboratory tests revealed an increased leukocyte count and elevated values of acute-phase proteins, but blood cultures were negative. Skin biopsy was performed and BA was diagnosed. The patient was given oral doxycycline 100 mg twice a day. During antibiotic therapy, his body temperature normalized and skin lesions began to resolve. The patient continued the above treatment for the next 3 months with good tolerance, and no relapse occurred in 1 year. CONCLUSION: BA should be listed among possible opportunistic infections in organ transplant recipients.