Knowledge Of Anatomy Research Articles

Anatomy of Inferior Mesenteric artery: A Cadaveric Study

Introduction: A comprehensive knowledge of the varied anatomy of the inferior mesenteric artery (IMA) can be important in surgeries in the region of the colon and rectum.Methods: We analyzed 50 fresh cadavers in the department of Anatomy, Faculty of Medicine Ragama from 2022 to 2024. Latarjet’s classification was used for the IMA branching pattern. The anatomical relationships of the IMA left colic artery (LCA), sigmoidal artery (SA), and superior rectal artery (SRA) were observed, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between LCA and inferior mesenteric vein (IMV) was also observed. The data was presented as the value / percentage.Results: Majority showed Type A branching pattern 35/50 (70%). The respective lengths from the origin of the IMA to the beginning of LCA were measured and expressed as (mm) (mean ± SD) for each type; Type A 33.4 ± 4.7, Type B 36.5 ± 5.4, Type C 39.2 ± 8.6. The number of LCA under IMV in type A (51%); type B (54%); type C (62%) respectively. There was no statistically significant difference among the three types.Conclusion: Our study showed that type A branching pattern of LCA was the commonest. It is also observed that almost similar incidence of LCA traversing above and beneath the IMV.

Model of Arteriovenous Malformation Created in Human Placenta for Training in Vascular Microneurosurgery.

Arteriovenous malformations (AVMs) are congenital lesions, and because of their structure, complexity, flow, size, and location organization, they are lesions that require extensive anatomic knowledge and mastery of microsurgical skills and techniques. Human placentas as a training model for AVM surgery are promising alternatives. This article aims to describe the technique for forming an AVM-type lesion in human placentas and its usefulness in the training of microsurgical treatment techniques. In this study, 15 fresh human placental models were treated. A nidus was created using synthetic material, and dynamic flow was evaluated with intravascular injection of Indocyanine Green. The catheter system was connected to a continuous flow infusion pump. For simulation purposes, 4 vascular neurosurgeons and 4 vascular neurosurgery fellows used the same techniques and instruments used in real surgery to simulate the resection of AVM lesions. Subjective assessments were conducted, evaluating the validity and structured content on a 5-point Likert scale. Evaluation criteria included the execution of technical maneuvers and the model's expression and structural aspects. We describe the step-by-step creation of an AVM in a placental biological model for the performance of vascular microsurgery training in the laboratory. We created in the human placenta a lesion with the characteristics of an AVM for microsurgical training in the laboratory, which presents key features realistic to a real AVM, such as 1 or more feeder arteries, nidus (synthetic), draining vein(s), continuous and pulsatile flow, and 3-dimensional configuration. Furthermore, it demonstrates the applicability of microsurgical techniques to the model compared with performing surgery on a patient. Considering it an effective method for laboratory training, the creation of arteriovenous malformations in human placentas enables students to replicate, comprehend the structure, and master microsurgical techniques in a realistic model.

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.

New anatomical findings in the mandibular body region: Two parts that make up bucco-mandibular space.

Soft tissue spaces not only enable gliding by contraction of the facial muscles, but they also cause drooping of the superficial fat due to gravity in the upright position. This study was performed to clarify the structures around the bucco-mandibular space (BMS) and to apply this anatomical knowledge to clinical practice. Four sides of the face were dissected using a conventional gross anatomical dissection technique, and 10 sides (5 horizontal and 5 frontal sections) of the removed semi-facial soft tissue were dissected using the stretched tissue dissection (STD) method. Histological examination of the mandible was performed on two sides to confirm the findings of conventional gross anatomical dissection and STD. In all cases, both gross dissection and STD revealed that the BMS was composed of two parts. The superficial part was filled with adipose tissue containing nerves and vessels, including the marginal mandibular branch of the facial nerve, facial artery, facial vein, and mental nerve. We named this part the adipo-neuromandibular part. By contrast, the deep part was separated from the adipo-neurovascular part by facial deep fascia and composed of loose connective tissue. We named this deep part the loose connective tissue part. The STD method enabled us to obtain detailed anatomical findings of the mandibular region and elucidate two parts of the BMS in which the neurovasculature is distributed. We believe that these findings provide new insights into facial anatomy by resolving existing anatomical uncertainties and will contribute to safer surgical treatment in the facial region.

Use of 3D foot and ankle puzzle enhances student understanding of the skeletal anatomy in the early years of medical school

Purpose3D visualization is an important part of learning anatomy with cadavers generally used to effectuate this. However, high cost, ethical considerations, and limited accessibility can often limit the suitability of cadavers as teaching tools. Anatomical 3D printed models offer an alternative tool for teaching gross anatomy due to their low cost and accessibility. This study aims to investigate if combing gamification with 3D printed models can enhance the learning experience and be effective for teaching anatomy.Methods3D printed models of the bones of the foot and ankle were generated, and 267 first-year medical students from 2 consecutive cohorts worked in groups to put it together as a puzzle. Participants completed a questionnaire regarding perceptions of 3D models and their knowledge of foot anatomy, before and after the session and were asked to provide comments.ResultsAnalysis of the responses showed a significant increase in the confidence of the learners in their anatomy knowledge and an increased appreciation of the role that 3D models have in enhancing the learning experience. After the session, there were many comments saying how enjoyable and engaging 3D models were.ConclusionThrough the puzzle element of the session, the students were challenged mentally to work out the anatomical features of the foot and ankle. The combined elements of the puzzle and the features of the 3D model assembly made the activity fun and conducive to active learning. The possibility of having fun was not something the students had considered before the session.

Effects of 3D Scans on Veterinary Students' Learning Outcomes Compared to Traditional 2D Images in Anatomy Classes.

Students often struggle with interpreting traditional textbook images and translating them to anatomical structures. This study aimed to compare the impact of 3D scans versus 2D images on students' learning outcomes when learning anatomical structures on skulls from horses and pigs. Furthermore, the correlation between spatial ability and learning outcomes using 3D scans or 2D images was examined. Second-year veterinary medicine students either used 3D scans or 2D images, annotated with arrows or numbers as learning material. Students' anatomical knowledge was tested before and after the learning session, and spatial ability was assessed using the mental rotation test. All groups improved significantly in the post-test. However, the differences between groups were not significant, suggesting that 3D scans do not necessarily lead to higher learning outcomes. The analysis of the correlation between spatial ability and learning outcomes did not prove that students with weaker spatial ability benefit from 3D scans. Students preferred 3D scans over 2D images despite similar outcomes, suggesting they are valuable for learning. However, results show that the introduction of novel learning materials likely amplified the impact of reduced learning time on the 3D group, as these materials necessitated additional time for effective comprehension and integration.

Les injections du front : anatomie, techniques, produits

Knowledge of anatomy not only allows optimal treatment and therefore full satisfaction of our patients, but is also fundamental in the prevention of complications. A thorough understanding of aging allows for effective treatments, as most patients demand a natural result, removing the inevitable signs of aging, which can only be understood by considering their aging. Facial aging is a natural but complex multifactorial process, particularly for the forehead. In this article, we will focus on botulinum toxin as well as fillers in aging.

Deep learning-based automated measurement of cervical length in transvaginal ultrasound images of pregnant women.

Cervical length (CL) measurement using transvaginal ultrasound is an effective screening tool to assess the risk of preterm birth. An adequate assessment of CL is crucial, however, manual sonographic CL measurement is highly operator-dependent and cumbersome. Therefore, a reliable and reproducible automatic method for CL measurement is in high demand to reduce inter-rater variability and improve workflow. Despite the increasing use of artificial intelligence techniques in ultrasound, applying deep learning (DL) to analyze ultrasound images of the cervix remains a challenge due to low signal-to-noise ratios and difficulties in capturing the cervical canal, which appears as a thin line and with extremely low contrast against the surrounding tissues. To address these challenges, we have developed CL-Net, a novel DL network that incorporates expert anatomical knowledge to identify the cervix, similar to the approach taken by clinicians. CL-Net captures anatomical features related to CL measurement, facilitating the identification of the cervical canal. It then identifies the cervical canal and automatically provides reproducible and reliable CL measurements. CL-Net achieved a success rate of 95.5% in recognizing the cervical canal, comparable to that of human experts (96.4%). Furthermore, the differences between the CL measurements of CL-Net and ground truth were considerably smaller than those made by non-experts and were comparable to those made by experts (median 1.36 mm, IQR 0.87-2.82 mm, range 0.06-6.95 mm for straight cervix; median 1.31 mm, IQR 0.61-2.65 mm, range 0.01-8.18 mm for curved one).

Is Conduction System Pacing Going to Be the New Gold Standard for Cardiac Resynchronization Therapy?

The current gold standard in device therapy for advanced heart failure (HF), which has been firmly established in HF management for more than 25 years, is classical biventricular pacing (BiV-CRT). In the last decade, a new pacing modality called conduction system pacing (CSP) has emerged as a variant for advanced cardiac device therapy. It provides pacing with preserved intrinsic cardiac activation by direct stimulation of the specific cardiac conduction system. The term CSP integrates the modalities of HIS bundle pacing (HBP) and left bundle branch area pacing (LBBAP), both of which have provided convincing data in smaller randomized and big non-randomized studies for the prevention of pacemaker-induced cardiomyopathy and for providing effective cardiac resynchronization therapy in patients with classical CRT-indication (primary approach or after failed CRT). Recent American guidelines proposed the term "cardiac physiological pacing" (CPP), which summarizes CSP including left ventricular septal pacing (LVSP), a technical variant of LBBAP together with classical BiV-CRT. The terms HOT-CRT (HIS-optimized CRT) and LOT-CRT (LBBP-optimized CRT) describe hybrid technologies that combine CSP with an additional coronary-sinus electrode, which is sometimes useful in patients with advanced HF and diffuse interventricular conduction delay. If CSP continues providing promising data that can be confirmed in big, randomized trials, it is likely to become the new gold standard for patients with an expected high percentage of pacing (>20%), possibly also for cardiac resynchronization therapy. CSP is a sophisticated new treatment option that has the potential to raise the term "cardiac resynchronization therapy" to a new level. The aim of this review is to provide basic technical, anatomical, and functional knowledge of these new pacemaker techniques in order to facilitate the understanding of the different modalities, as well as to provide an up-to-date overview of the existing randomized and non-randomized evidence, particularly in direct comparison to right ventricular and classical biventricular pacing.

Reconstruction of Knowledge and Medical Images in the Convergence of Chinese and Western Medicine ——Taking “Sweet Meat” as an Example

Abstract: The pancreas is neither part of the five Zang organs (五脏) nor the six Fu organs (六腑). Thus, it has received little attention in Chinese medical literature. In the late 19th century, medical missionaries in China started translating and introducing anatomical and physiological knowledge about the pancreas. As for the word pancreas, an early and influential translation was “sweet meat” (甜肉), proposed by Benjamin Hobson (合信). The translation “sweet meat” is not faithful to the original meaning of “pancreas”, but is a term coined by Hobson based on his personal habits, and the word “sweet” appeared by chance. However, in the decades since the term “sweet meat” became popular, Chinese medicine practitioners, such as Tang Zonghai (唐宗海), reinterpreted it by drawing new medical illustrations for “sweet meat” and giving new connotations to the word “sweet”. This discussion and interpretation of “sweet meat” in modern China, particularly among Chinese medicine professionals, is not only a dissemination and interpretation of the knowledge of “pancreas”, but also a construction of knowledge around the term “sweet meat”.

The Anatomy of the Thoracic Duct and Cisterna Chyli: A Meta-Analysis with Surgical Implications.

Background: The thoracic duct (TD) and the cisterna chyli (CC) exhibit a high degree of variability in their topographical and morphometric properties. Materials and Methods: PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to identify all studies that included information regarding the morphometric and topographical characteristics of the TD and CC. Results: The most frequent location of the TD termination was the left venous angle, with a pooled prevalence of 45.29% (95% CI: 25.51-65.81%). Moreover, the TD terminated most commonly as a single vessel (pooled prevalence = 78.41%; 95% CI: 70.91-85.09%). However, it divides into two or more terminating branches in approximately a quarter of the cases. The pooled prevalence of the CC was found to be 55.49% (95% CI: 26.79-82.53%). Conclusions: Our meta-analysis reveals significant variability in the anatomy of the TD and CC, particularly regarding TD termination patterns. Despite the predominance of single-vessel terminations, almost a quarter of cases exhibit branching, highlighting the complexity of the anatomy of the TD. These findings demonstrate the importance of detailed anatomical knowledge for surgeons to minimize the risk of accidental injury during head and neck, as well as thoracic surgeries. Our study provides essential insights that can enhance surgical safety and efficacy, ultimately improving patient outcomes.

Modified Rosi–Cahill technique after left extended colectomy for splenic flexure advanced tumors

Advanced splenic flexure tumors are uncommon and have a higher risk of relapse. To ensure that the resection includes the entire area of lymphatic drainage with a complete mesocolic excision (CME), a left extended colectomy is needed. In peritoneal carcinomatosis, there is often extensive involvement of the sigma and splenic flexure of the colon. In many instances, total colectomies are chosen for these patients, even when a significant portion of the colon could be preserved. The potential impact on quality of life after splenic flexure colon resection is discussed, as well as the importance of anatomical knowledge and expertise in performing this type of surgery. Overall, this work presents a modified technique that aims to improve the outcomes and quality of life for patients with splenic flexure colon cancer. Creating a tension-free anastomosis after extended left-sided colorectal resection is challenging. There is a negative impact on quality of life when an ileorectal anastomosis is created. The colorectal anastomosis performed after modified Rosi–Cahill or Deloyers’ technique allows reduced small bowel bacterial overgrowth, achieves better water and sodium absorption, and altogether permits improved stool consistency. There are potential advantages of the Rosi–Cahill technique over other popular options such as Deloyers’ procedure as there is no torsion of the ileocolic vessels and no mesenteric windows. A video was recorded showing a potential pitfall during Deloyers’ technique resulting in the creation of a mesenteric window. The proper rotation of the colon during the modified Rosi–Cahill procedure was also filmed. Overall, this work presents a modified technique for reconstruction after left extended colectomy that aims to improve the outcomes and quality of life for patients with splenic flexure colon cancer.

Adverse Effects Associated with Dermal Filler Treatments: Part II Vascular Complication.

Vascular complications arising from dermal filler treatments pose significant risks, including ischemia, tissue necrosis, and severe outcomes like blindness and pulmonary embolism. This study investigates the mechanisms of vascular complications, categorizing them into extravascular compression and intravascular emboli. Extravascular compression occurs when injected fillers compress adjacent blood vessels, leading to ischemia and potential necrosis, while intravascular emboli result from fillers entering blood vessels, causing blockages. The study emphasizes the importance of anatomical knowledge, careful injection techniques, and early intervention. Management strategies include the use of hyaluronidase to dissolve HA fillers, vasodilators to improve blood circulation, and hyperbaric oxygen therapy. The regions most susceptible to complications align with major arterial pathways, particularly the nasolabial folds and nasal region. The study also highlights the need for meticulous injection techniques, the use of cannulas over needles in high-risk areas, and the aspiration test to detect vessel penetration. Early detection and immediate intervention are crucial to mitigate adverse outcomes. Continuous education and training for practitioners, along with advancements in filler materials and injection methods, are essential for improving the safety of cosmetic procedures. This comprehensive understanding aids in preventing and managing vascular complications, ensuring better patient outcomes. The field of dermal filler treatments is advancing with new techniques and technologies, such as High-Resolution Ultrasound, Infrared Imaging, self-crossing hyaluronic acid filler, biodegradable microspheres, and microinjection.

Novel Domain Knowledge-Encoding Algorithm Enables Label-Efficient Deep Learning for Cardiac CT Segmentation to Guide Atrial Fibrillation Treatment in a Pilot Dataset.

Background: Segmenting computed tomography (CT) is crucial in various clinical applications, such as tailoring personalized cardiac ablation for managing cardiac arrhythmias. Automating segmentation through machine learning (ML) is hindered by the necessity for large, labeled training data, which can be challenging to obtain. This article proposes a novel approach for automated, robust labeling using domain knowledge to achieve high-performance segmentation by ML from a small training set. The approach, the domain knowledge-encoding (DOKEN) algorithm, reduces the reliance on large training datasets by encoding cardiac geometry while automatically labeling the training set. The method was validated in a hold-out dataset of CT results from an atrial fibrillation (AF) ablation study. Methods: The DOKEN algorithm parses left atrial (LA) structures, extracts "anatomical knowledge" by leveraging digital LA models (available publicly), and then applies this knowledge to achieve high ML segmentation performance with a small number of training samples. The DOKEN-labeled training set was used to train a nnU-Net deep neural network (DNN) model for segmenting cardiac CT in N = 20 patients. Subsequently, the method was tested in a hold-out set with N = 100 patients (five times larger than training set) who underwent AF ablation. Results: The DOKEN algorithm integrated with the nn-Unet model achieved high segmentation performance with few training samples, with a training to test ratio of 1:5. The Dice score of the DOKEN-enhanced model was 96.7% (IQR: 95.3% to 97.7%), with a median error in surface distance of boundaries of 1.51 mm (IQR: 0.72 to 3.12) and a mean centroid-boundary distance of 1.16 mm (95% CI: -4.57 to 6.89), similar to expert results (r = 0.99; p < 0.001). In digital hearts, the novel DOKEN approach segmented the LA structures with a mean difference for the centroid-boundary distances of -0.27 mm (95% CI: -3.87 to 3.33; r = 0.99; p < 0.0001). Conclusions: The proposed novel domain knowledge-encoding algorithm was able to perform the segmentation of six substructures of the LA, reducing the need for large training data sets. The combination of domain knowledge encoding and a machine learning approach could reduce the dependence of ML on large training datasets and could potentially be applied to AF ablation procedures and extended in the future to other imaging, 3D printing, and data science applications.

Totally Extra Peritoneal Management of Inguinal Hernia Repair: Our Experience in a Public Sector Hospital

Objective: The study objective is to analyze the clinical effectiveness and efficiency of laparoscopic TEP in our set up and to determine its surgical outcomes regarding incidence of early and late post-operative complications. Materials and Methods: A retrospective descriptive study was conducted at Surgical Unit II, Benazir Bhutto Hospital, Rawalpindi Medical University for 5 years and 6 months from January 2018 to June 2023. After approval from the ethical board, data was collected as a qualitative research study through focus group interviews. Adult patients aged between 20 to 70 years, selected by retrospective consecutive sampling who were presented in surgical OPD with unilateral, bilateral, or recurrent inguinal hernia, underwent laparoscopic TEP hernia repair. Patients were reviewed on 1st post-operative day, during 1st week, and at 6 months to 1 year post-surgery. Data was entered into a standard SPSS sheet version 26. Results: The primary outcomes were evaluated based on early postoperative complications including wound infection, seromas or hematoma, urinary retention and abscess formation or mesh infection, and late complications including recurrence and chronic pain. Clear advantages were observed for the laparoscopic TEP technique regarding early return to normal daily activities due to reduced postoperative complications. Conclusions: The newer advanced concepts in hernia surgeries have proven to have good control over early complications, and postoperative pain, with minimal recurrence. Surgeons should acquire adequate experience and anatomical knowledge before performing this advanced inguinal repair surgery.

Anatomical considerations of medial eye wrinkles: Guidelines for botulinum neurotoxin injections.

Crow's feet lines in the lateral canthal region are a common concern among aging patients, initially appearing as dynamic wrinkles during facial expressions and becoming more pronounced with age. Botulinum neurotoxin temporarily paralyzes muscles by inhibiting acetylcholine release, smoothing wrinkles and enhancing skin's youthful appearance. Effective treatment requires tailored approaches considering individual anatomy and muscle activity. Recent cadaveric studies identified the tear trough muscle, emphasizing its role in infraorbital support and aging. Clinically, patients often present medial eye wrinkles after BoNT treatment for crow's feet, prompting exploration of underlying mechanisms and management strategies. Three cases demonstrated that medial BoNT injections in the orbicularis oculi muscle significantly improve medial eye wrinkles and tear trough appearance. The study underscores the importance of understanding muscle hyperactivity and anatomical variations for precise treatment. Enhanced injection techniques targeting specific areas can achieve better outcomes and minimize complications, particularly in culturally sensitive regions where facial expressions are valued. This research highlights the necessity for comprehensive anatomical knowledge and patient-specific treatment strategies to address medial eye wrinkles effectively.

Head of Zebu cattle (Bos Taurus indicus): sectional anatomy and 3D computed tomography

The research was designed to use computed tomography (CT) with 3D-CT reconstruction imaging techniques and the various anatomical sections—plana transversalia, frontalis, and dorsalia—to describe the anatomical architecture of the Zebu cattle head. Our study used nine mature heads. The CT bone window created detailed images of cranial bones, mandibles, teeth, and hyoid bones. All of the head cavities were evaluated, including the cranial, orbital, oral, auricular, and nasal cavities with their paranasal and conchal sinuses. The septum nasi, attached to the vomer and maxillary bones, did not reach the nasal cavity floor caudally at the level of the second premolar teeth, resulting in a single median channel from the choanae to the nasopharynx. The positions, boundaries, and connections of the paranasal sinuses were clearly identified. There were four nasal conchal sinuses (that were named the dorsal, middle, ethmoidal, and ventral) and five paranasal sinuses that were described as the following: sinus frontalis, maxillaris, palatinorum, and lacrimalis, as defined in the different anatomical sections and computed tomographic images. The complicated sinus frontalis caused the pneumatization of all bones that surrounded the cranial cavity, with the exception of the ethmoidal and body of basisphenoid bones. The sinus maxillaris was connected to the sinus lacrimalis and palatinorum through the maxillolacrimal and palatomaxillary openings, and to the middle nasal meatus through the nasomaxillary opening. Our findings provide a detailed anatomical knowledge for disease diagnosis to internal medicine veterinarians and surgeons by offering a comprehensive atlas of the Zebu cattle anatomy.

MORPHOMETRIC VARIATION OF FORAMEN OVALE IN DRY ADULT SKULL OF INDIAN POPULATION WITH CLINICAL CORRELATIONS

Objective: The present study aim is to evaluate morphology and morphometric measurements of foramen Ovale present in the Greater wing of Sphenoid bone of the Middle Cranial fossa of the Skull base, using Digital sliding Vernier caliper. The anatomical knowledge of Foramen Ovale and it’s variations are of great help to neurosurgeons, oncologists and radiologists while performing any diagnostic and surgical interventions into and nearby foramen to deal with unavoidable complications as Tic douloureux. Methods: This study was done in 35 dried Human skulls taken from the Department of Anatomy, GBCM, Dehradun, India. The length and the width of the Foramen Ovale were measured. The different shapes of the foramen were also seen. All data collected was subjected to Statistical analysis using Student’s T-test. Results: In the present study, Incidence of Oval shape foramen Ovale was maximum, followed by Elongated shape. There were no statistical differences between the mean length and mean width on the two sides of Foramen Ovale. Conclusion: The vast knowledge of different shapes and sizes of foramen Ovale to Neurosurgeons and Oncologists helps to operate with least invasive procedures to avoid clinical manifestations.

Immersive Surgical Anatomy of the Venous Drainage and Meningeal Supply of the Posterior Fossa: Anatomical Nuances and Microsurgical Management of Dural Arteriovenous Fistulas (dAVFs).

Dural arteriovenous fistulas (dAVFs) are anomalous connections between arteries and veins within the dura mater, involving dural sinuses, bridging veins, or emissary veins. If untreated, these lesions can result in intracranial hemorrhage. The management of posterior fossa dAVFs is challenging due to the intricate venous anatomy near the brainstem and cranial nerves. This study leverages three-dimensional (3D) technology combined with dissections to understand the anatomy and microsurgical techniques for treating infratentorial dAVFs.Five embalmed heads and one dry skull were used to meticulously document the pertinent anatomy of the infratentorial compartment. Advanced 3D technology, including 3D sculpting and structured light scanning, was employed to constructhigh-resolution volumetric models (VMs). Two-dimensional (2D) images of dissections and VMs illustrate key anatomical landmarks of the posterior fossa.Infratentorial dAVFs primarily involve sinuses, which are divided into groups based on their location: basal, medullary, and petrosal. Most of the arterial supply originates from the external carotid artery, especially the ascending pharyngeal artery. This is followed by meningeal branches from the internal carotid artery (ICA) and vertebrobasilar system. The surgical approaches to treat infratentorial dAVFs include the retrosigmoid and far lateral approaches and their modifications. Our study describes the relevant vascular anatomy of the infratentorial compartment, focusing on the surgical treatment of infratentorial dAVFs. In conjunction with the included interactive models, this study improves our educational capabilities regarding the intricate vascular neuroanatomical features of this region. When applied to a clinical setting, precise anatomical knowledge and VMs tools enhance surgical outcomes, reduce complications, and ultimately improve patient care.

A case of death after the severing three appendiceal arteries during appendectomy.

Acute appendicitis is one of the most common acute abdominal issues requiring surgery and is usually treated by appendectomy. During the process of removing the appendix, the appendiceal artery is severed. In most individuals, the appendix is supplied by only one appendiceal artery. A 50-year-old man underwent appendectomy. During the surgical procedure, the appendix artery and two accessory arteries of the appendix were severed, leading to massive hemorrhaging in the abdominal cavity, which ultimately resulted in the patient's unfortunate demise. Through this case, we hope that surgeons can learn more about the anatomy of the appendiceal artery and understand the possibility of accessory arteries to the appendix. During surgery, the blood vessels supplying the appendix should be carefully explored, and the "one-size-fits-all approach" should be avoided. Moreover, attention should be given to complications after appendectomy, and timely symptomatic treatment should be provided. Key points 1. Rare typing: The case of death due to improper handling of the accessory appendicular artery during appendectomy in patients with three appendiceal arteries is currently unreported. 2. Detailed anatomical knowledge: Surgeons performing an appendectomy need to make a detailed exploration of the blood vessel supply of the appendix to avoid ignoring anatomically different blood vessels. 3. Avoid a one-size-fits-all approach: In the surgical process, a "one-size-fits-all" approach should be avoided, that is, the same surgical approach should not be used in all cases, but should be adjusted according to the anatomical characteristics of the individual. 4. Observation of postoperative bleeding: In the perioperative period, peritoneal drainage should be closely observed. If a large amount of bloody fluid is found, timely surgical treatment should be carried out. 5. Attention to complications: Surgeons should pay.