1.Tangled Throughout Life: A Case of Paediatric Ruptured Cerebral Arteriovenous Malformation
Syed Muhammad Hafiz Syed Hassan ; Nurul Huda Ahmad
Malaysian Journal of Medicine and Health Sciences 2021;17(No.4):413-415
Arteriovenous malformation (AVM) in children is uncommon occurrence defined as presence of arteriovenous shunting through coiled and tortuous vascular connections. We discussed a case of a 3-year old girl presented with acute
left facial asymmetry and right-sided limb weakness. Neurological examination revealed MRC scale of 0 out of 5 for
power on her right side. Magnetic Resonance Angiography (MRA) revealed bilateral thalamic AVM. Surgical resection was not advisable in view of deep-seated location. Paediatric AVM most often become apparent following rupture with majority presents with headache. Ruptured paediatric AVM carries high burden of morbidity and mortality.
Paediatric intracranial haemorrhage posed tremendous concern regarding its long-term outcome. Treatment would
be more appropriate sooner rather than later especially for those presented with ruptured AVM. Surgical resection
remains the gold standard treatment for all accessible paediatric AVMs with embolization and radiosurgery as adjunctive therapies. AVM in paediatric population is rare but carries grim prognosis.
2.Facial Muscles and Its Modiolus: A Review of Embryology, Comparative Anatomy, Morphology and Applied Anatomy
Razif Abas ; Choy Ker Woon ; Aspalilah Alias ; Mohd Amir Kamaruzzaman ; Nor Farid Mohd Noor ; Ahmad Mukifza Harun ; Nurul Huda Mohd Nor
Malaysian Journal of Medicine and Health Sciences 2021;17(No.4):313-319
The modiolus of the face manifests the interesting landmark for facial muscles attachment. The strong connective
tissue fibres play an important role in the clinical setting, especially in the aesthetic and dental surgeries. In the fourth
week of intrauterine life, the development of the modiolus evolves in accordance with the growth of muscles of facial
expression. Microscopically, a white, tendinous structure with the thick irregular collagenous connective tissue of
collagen fibres predominance appeared to be the modiolus. Modiolus is morphologically a fibromuscular muscle
situated on the lateral border of the mouth. The formation of the nasolabial fold is important and a well-developed
modiolus provide a toned face. Several works of literature forementioned the number of facial muscles attached to
the modiolus but no definitive similarity are identified. This review summarizes the updated morphological features
and applied anatomy of the facial modiolus with its muscle attachment.