To review morphometry, morphology, branching patterns and anomalies of middle cerebral artery (MCA). The databases of PubMed, Google Scholar and Scopus were searched with different keywords. The review comprised of 45 studies.Meta-analysis was done for dimensions of MCA, shapes, patterns and MCA anomalies. Newcastle-Ottawa Scale was used for assessment of literature. Statistical analysis was done using R software using meta package. Thirteen research were combined to determine the proportion of MCA length and pooled proportion was 16.53 cm (15.33 to 17.72 cm); I2 =98%; P-value<0.01.Nine studies were combined to determine proportion of MCA diameter and pooled proportion was 2.85 cm (2.52 to 3.17 cm); I2 =100%; P-value<0.05. M1 segment mean length is more on left side as compared to right side. Mean length in males (16.57±1.40 cm) is more than females (15.9±1.32 cm). Mean diameter of M1 segment is similar on both sides. Mean diameter in males (3.20±0.09 cm) is higher than females (3.14±0.18 cm). Different branching patterns observed were single trunk, early bifurcation, bifurcation, trifurcation, quadrifurcation and multiple trunks. The most typical MCA branching pattern is bifurcation. The shapes of MCA like straight shaped, U shaped, C shaped, inverted U shaped and S-shaped of M1 segment have been described. Straight MCA is the most common shape. The MCA measurements and branching pattern will assist surgeons in limiting errors in the treatment of cerebral aneurysms and infarcts and providing the best possible result for the patients. An understanding of MCA shape will aid surgeons and physicians in effective endovascular recanalization.

To review morphometry, morphology, branching patterns and anomalies of middle cerebral artery (MCA). The databases of PubMed, Google Scholar and Scopus were searched with different keywords. The review comprised of 45 studies.Meta-analysis was done for dimensions of MCA, shapes, patterns and MCA anomalies. Newcastle-Ottawa Scale was used for assessment of literature. Statistical analysis was done using R software using meta package. Thirteen research were combined to determine the proportion of MCA length and pooled proportion was 16.53 cm (15.33 to 17.72 cm); I2 =98%; P-value<0.01.Nine studies were combined to determine proportion of MCA diameter and pooled proportion was 2.85 cm (2.52 to 3.17 cm); I2 =100%; P-value<0.05. M1 segment mean length is more on left side as compared to right side. Mean length in males (16.57±1.40 cm) is more than females (15.9±1.32 cm). Mean diameter of M1 segment is similar on both sides. Mean diameter in males (3.20±0.09 cm) is higher than females (3.14±0.18 cm). Different branching patterns observed were single trunk, early bifurcation, bifurcation, trifurcation, quadrifurcation and multiple trunks. The most typical MCA branching pattern is bifurcation. The shapes of MCA like straight shaped, U shaped, C shaped, inverted U shaped and S-shaped of M1 segment have been described. Straight MCA is the most common shape. The MCA measurements and branching pattern will assist surgeons in limiting errors in the treatment of cerebral aneurysms and infarcts and providing the best possible result for the patients. An understanding of MCA shape will aid surgeons and physicians in effective endovascular recanalization.

To review morphometry, morphology, branching patterns and anomalies of middle cerebral artery (MCA). The databases of PubMed, Google Scholar and Scopus were searched with different keywords. The review comprised of 45 studies.Meta-analysis was done for dimensions of MCA, shapes, patterns and MCA anomalies. Newcastle-Ottawa Scale was used for assessment of literature. Statistical analysis was done using R software using meta package. Thirteen research were combined to determine the proportion of MCA length and pooled proportion was 16.53 cm (15.33 to 17.72 cm); I2 =98%; P-value<0.01.Nine studies were combined to determine proportion of MCA diameter and pooled proportion was 2.85 cm (2.52 to 3.17 cm); I2 =100%; P-value<0.05. M1 segment mean length is more on left side as compared to right side. Mean length in males (16.57±1.40 cm) is more than females (15.9±1.32 cm). Mean diameter of M1 segment is similar on both sides. Mean diameter in males (3.20±0.09 cm) is higher than females (3.14±0.18 cm). Different branching patterns observed were single trunk, early bifurcation, bifurcation, trifurcation, quadrifurcation and multiple trunks. The most typical MCA branching pattern is bifurcation. The shapes of MCA like straight shaped, U shaped, C shaped, inverted U shaped and S-shaped of M1 segment have been described. Straight MCA is the most common shape. The MCA measurements and branching pattern will assist surgeons in limiting errors in the treatment of cerebral aneurysms and infarcts and providing the best possible result for the patients. An understanding of MCA shape will aid surgeons and physicians in effective endovascular recanalization.

To review morphometry, morphology, branching patterns and anomalies of middle cerebral artery (MCA). The databases of PubMed, Google Scholar and Scopus were searched with different keywords. The review comprised of 45 studies.Meta-analysis was done for dimensions of MCA, shapes, patterns and MCA anomalies. Newcastle-Ottawa Scale was used for assessment of literature. Statistical analysis was done using R software using meta package. Thirteen research were combined to determine the proportion of MCA length and pooled proportion was 16.53 cm (15.33 to 17.72 cm); I2 =98%; P-value<0.01.Nine studies were combined to determine proportion of MCA diameter and pooled proportion was 2.85 cm (2.52 to 3.17 cm); I2 =100%; P-value<0.05. M1 segment mean length is more on left side as compared to right side. Mean length in males (16.57±1.40 cm) is more than females (15.9±1.32 cm). Mean diameter of M1 segment is similar on both sides. Mean diameter in males (3.20±0.09 cm) is higher than females (3.14±0.18 cm). Different branching patterns observed were single trunk, early bifurcation, bifurcation, trifurcation, quadrifurcation and multiple trunks. The most typical MCA branching pattern is bifurcation. The shapes of MCA like straight shaped, U shaped, C shaped, inverted U shaped and S-shaped of M1 segment have been described. Straight MCA is the most common shape. The MCA measurements and branching pattern will assist surgeons in limiting errors in the treatment of cerebral aneurysms and infarcts and providing the best possible result for the patients. An understanding of MCA shape will aid surgeons and physicians in effective endovascular recanalization.

To review morphometry, morphology, branching patterns and anomalies of middle cerebral artery (MCA). The databases of PubMed, Google Scholar and Scopus were searched with different keywords. The review comprised of 45 studies.Meta-analysis was done for dimensions of MCA, shapes, patterns and MCA anomalies. Newcastle-Ottawa Scale was used for assessment of literature. Statistical analysis was done using R software using meta package. Thirteen research were combined to determine the proportion of MCA length and pooled proportion was 16.53 cm (15.33 to 17.72 cm); I2 =98%; P-value<0.01.Nine studies were combined to determine proportion of MCA diameter and pooled proportion was 2.85 cm (2.52 to 3.17 cm); I2 =100%; P-value<0.05. M1 segment mean length is more on left side as compared to right side. Mean length in males (16.57±1.40 cm) is more than females (15.9±1.32 cm). Mean diameter of M1 segment is similar on both sides. Mean diameter in males (3.20±0.09 cm) is higher than females (3.14±0.18 cm). Different branching patterns observed were single trunk, early bifurcation, bifurcation, trifurcation, quadrifurcation and multiple trunks. The most typical MCA branching pattern is bifurcation. The shapes of MCA like straight shaped, U shaped, C shaped, inverted U shaped and S-shaped of M1 segment have been described. Straight MCA is the most common shape. The MCA measurements and branching pattern will assist surgeons in limiting errors in the treatment of cerebral aneurysms and infarcts and providing the best possible result for the patients. An understanding of MCA shape will aid surgeons and physicians in effective endovascular recanalization.

STUDY DESIGN: Prospective study. PURPOSE: To establish the significance of cerebrospinal fluid (CSF) nitric oxide metabolite (NOx) concentration in acute spinal cord injury (SCI) patients to assess the neurological severity and prognosis. OVERVIEW OF LITERATURE: Quantitative analysis of specific biomarkers in CSF will assess neurological severity more accurately and permit the formulation of a more precise management plan. METHODS: Forty SCI patients represented the cases and 20 lower limb injury patients were the controls. NOx concentration in CSF was measured at week 1, 2, and 4 by Griess method. Magnetic resonance imaging (MRI, T2-weighted) done in each case to measure cord edema and neurological severity was assessed using the Frankel classification. RESULTS: CSF NOx concentration peaked at week 2 and declined to normal by week 4. The concentration remained normal in controls. Mean NOx concentration was directly proportional to the severity of acute SCI as correlated with cord edema seen in MRI and neurological severity assessed. CONCLUSIONS: CSF NOx concentration can be considered a specific quantitative biomarker in acute stage of SCI to predict the severity and prognosis of SCI patients.
Biomarkers ; Cerebrospinal Fluid* ; Classification ; Edema ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Methods ; Nitric Oxide* ; Prognosis ; Prospective Studies ; Spinal Cord Injuries

Ulnar nerve injury in closed fracture of forearm in children is uncommon.Commonly, neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases. The importance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management.We present a case of ulnar nerve deficit in a child following a closed fracture of the forearm bones. It is imperative to diagnose exact cause of palsy as it forms the basis for treatment. MRI scan can help diagnosis and accordingly guide the management. Simple nerve contusion should be treated conservatively, and exploration with fixation of the fracture should be done in lacerations and entrapments of the nerve. Surgery is not the treatment of choice in cases that could be managed conservatively.
Accidental Falls ; Child ; Diagnostic Errors ; Fractures, Closed ; complications ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging ; Radius Fractures ; complications ; diagnosis ; therapy ; Ulna Fractures ; complications ; diagnosis ; therapy ; Ulnar Nerve ; injuries ; Ulnar Neuropathies ; diagnosis ; etiology

PURPOSE: The medial patellofemoral ligament (MPFL) acts as primary restraint to lateral patellar dislocation and its rupture has been reported in almost all cases of acute patellar dislocation. Various surgical techniques have been described for MPFL reconstruction, using many femoral and patellar fixation techniques and different grafts. This article details our technique for MPFL reconstruction using semitendinosus graft which avoids the use of implant at patellar end. METHODS: Twenty patients (8 males and 12 females) with complaints regarding acute and chronic lateral patellar instability were evaluated and treated by MPFL reconstruction procedure. The mean age of patients was 21 years (range 17-34 years). MPFL reconstruction was performed using semitendinosus graft passing through two parallel, obliquely directed tunnels created in patella. Fixation of graft was done with an interference screw only at the femoral end. Mean follow-up period after intervention was 26.4 months (range 23-30 months). Results were evaluated using Kujala score. RESULTS: All patients gained adequate patellar stability and full arc of motion. No incidence of patella fracture was noted. There were no postoperative complications related to the procedure. There was no recurrence of instability in patella at final follow-up. CONCLUSION Passing the graft through the tunnels in patella without use of any implant has given excellent functional outcome and moreover has the advantages of less implant-related complications and cost-effectiveness.