Morphometric analysis of hemicerebellar asymmetryn with central vertigo cases: a stereological study / Análisis morfométrico de la asimetría hemicerebelar en casos de vértigo central: un estudio estereológico

We aimed to evaluate the relevant methods of stereology to estimate hemicerebellar asymmetry according to sex in both adult right handed vertigo cases and comparing with healthy cases. The study included 14 adult control subjects and 18 patients with vertigo. The volumes of the cerebellar hemispheres were determined by MRI using the point-counting approach of stereological methods. The mean ( +/- SD) of the right cerebellar hemispheres in the patients with vertigo were 52.49 +/-5.42 cm3 in males, 50.11 +/- 4.02 cm3 in females. The mean ( +/- SD) of the left cerebellar hemispheres in the patients with vertigo were 53.11 +/- 3.70 cm3 in males, 49.73 +/- 4.69 cm3 in females. There was not significant quantitative evidence detected in terms of cerebella asymmetry between sagittal plane estimates in the cases with vertigo in both genders (p>0.05). There were no statistically significant differences according to the genders between both vertigo and control subjects (p>0.05). There was only statistical significance between right and left hemispheres in male control subjects (p=0.039). There was no cerebella asymmetry between control and vertigo cases according to genders. The stereological evaluation of cerebella asymmetry or atrophy in humans correlate with gender is of importance for both clinicians and anatomists. The technique is simple, reliable, inexpensive and unbiased.

Nuestro objetivo fue evaluar los métodos relevantes de estereología para estimar la asimetría hemicerebellar según el género, tanto en adultos diestros, casos de vértigo y al compararlos con casos control. El estudio incluyó a 14 sujetos adultos como control y 18 pacientes con vértigo. Los volúmenes de los hemisferios del cerebelo se determinaron en la RM utilizando el recuento de los puntos del método de estereología. La media ( +/- DE) de los hemisferios derecho del cerebelo en los pacientes con vértigo fueron 52,49 +/- 5,42 cm3 en los hombres, 50,11 +/- 4,02 cm3 en las mujeres. La media ( +/- DE) de los hemisferios izquierdo del cerebelo en los pacientes con vértigo fueron 53,11 +/- 3,70 cm3 en los hombres, 49,73 +/- 4,69 cm3 en las mujeres. No hubo evidencia cuantitativa importante detectada en cuanto a la asimetría entre las estimaciones del cerebelo entre plano sagital en los casos con vértigo en ambos sexos (p> 0,05). No hubo diferencias estadísticamente significativas según los géneros entre ambos el vértigo y los sujetos control (p> 0,05). Sólo hubo significancia estadística entre los hemisferios derecho e izquierdo en los sujetos control masculino (p = 0,039). No hubo asimetría entre el cerebelo control y de los casos el vértigo de acuerdo a los géneros. La evaluación de la asimetría estereológica o atrofia del cerebelo en el ser humano se correlaciona con el género es de importancia para los clínicos y anatómicos. La técnica es simple, confiable, de bajo costo e imparcial.

Evaluation of cerebellar asymmetry with vertigo cases: a stereological study.

AIM: We aimed to evaluate the relevant methods of stereology to estimate cerebellar asymmetry according to gender in both adult right-handed vertigo cases and healthy cases. MATERIAL AND METHODS: The study included 14 adult control subjects and 18 patients with vertigo. The volumes of the cerebellar hemispheres were determined on MRI using the point-counting approach of stereological methods. RESULTS: The mean (+/-SD) of the right cerebellar hemispheres in the patients with vertigo were 52.49+/-5.42 cm3 in males, 50.11+/-4.02 cm3 in females. The mean (+/-SD) of the left cerebellar hemispheres in the patients with vertigo were 53.11+/-3.70 cm3 in males and 49.73+/-4.69 cm3 in females. There was no significant quantitative evidence detected in terms of cerebellar asymmetry between sagittal plane estimates in the cases with vertigo in both genders (p > 0.05). There were no statistically significant differences by genders between vertigo and control subjects (p > 0.05). There was statistical significance only between right and left hemispheres in male control subjects (p=0.039) CONCLUSION: There was no cerebellar asymmetry between control and vertigo cases by gender. The stereological evaluation of cerebellar asymmetry or atrophy in humans in correlation with gender is of importance both for clinicians and anatomists. The technique is simple, reliable, inexpensive and unbiased.

The premasseteric branch of facial artery: its importance for craniofacial surgery.

AIM: The masseter muscle is often exploited by craniofacial surgeons in transposition operations to correct facial palsy, benign masseteric hypertrophy; or neurectomy-induced atrophy of the muscle. A clear understanding of the course of the premasseteric branch of the facial artery and its relations with adjacent structures is essential in maneuvering the masseter muscle safely. In the present study the premasseteric branch was analyzed in details. MATERIAL AND METHODS: Neurovascular and anatomical features and relations of the premasseteric branch and its branches were evaluated according to location, origin, diameter, length and course by bilateral meticulous anatomic micro dissection under 4x loop magnification in formalin fixed 14 adult preserved cadavers. RESULTS: The premasseteric branch originated separately from the facial artery in all cases. The course of the branch was observed to the upper anterior border of the masseter muscle. The diameter of the premasseteric branch was 1.12 mm (mean) at the level of origin. The diameter of the premasseteric branch was larger than the facial artery in 3% of cases. The location of the branch was defined according to body of the mandible. Branches and anastomoses of the premasseteric branch were also represented. CONCLUSION: Anatomical data of the premasseteric branch will help craniofacial surgeons elevate flaps safely.

Stereological evaluation of volumetric asymmetry in healthy human cerebellum.

OBJECTIVES: Age-related volumetric differences in brain anatomy or volumetric brain analyses in many disorders are of interest. Delineating the normal anatomical cerebellar volume is of importance for both the anatomists and clinicians. In the present study, we aimed to evaluate the cerebellar volume using a stereological technique and to determine the possible volumetric asymmetry depending on age and gender. MATERIALS AND METHODS: Volumetric asymmetry of cerebellar hemispheres was evaluated using stereological method on the magnetic resonance images (MRI) of healthy male and female subjects. Randomly selected individuals (27 males, 27 females) aged between 10-86 years who have normal brain MRI were enclosed in the study. All the subjects were right handed. The individuals were divided into three groups according to age as 18-34 (young), 35-60 (middle aged) and 60-84 (elder) and their MRI images were analyzed. The data set were analyzed by two factor repeated measure analysis. RESULTS: Although the cerebellum was smaller between young and middle aged groups and also middle aged and elder groups, there were no any statistically significant differences between compared groups' mean (P > 0.05). There were not statistically differences according to sex and age groups (P > 0.05). CONCLUSIONS: There was no cerebellar asymmetry between compared groups. The stereological evaluation of cerebellar asymmetry in humans correlate with both gender and age groups is of importance for both clinicians and anatomists. The technique is simple, reliable, unbiased and inexpensive.