Title

Microsurgical Approaches to the Ambient Cistern Region: An Anatomic and Qualitative Study

Document Type

Article

Abstract

© 2016 Elsevier Inc. All rights reserved. Objective We used microscopy to conduct qualitative and quantitative analysis of 4 surgical approaches commonly used in the surgery of the ambient cistern: infratentorial supracerebellar (SC), occipital interhemispheric, subtemporal (ST), and transchoroidal (TC). In addition, we performed a parahippocampal gyrus resection in the ST context. Methods Each approach was performed in 3 cadaveric heads (6 sides). After the microscopic anatomic dissection, the parahippocampal gyrus was resected through an ST approach. The qualitative analysis was based on anatomic observation and the quantitative analysis was based on the linear exposure of vascular structures and the area of exposure of the ambient cistern region. Results The ST approach provided good exposure of the inferior portion of the cistern and of the proximal segments of the posterior cerebral artery. After the resection of the parahippocampal gyrus, the area of exposure improved in all components, especially the superior area. A TC approach provided the best exposure of the superior area compared with the other approaches. The posterolateral approaches (SC/occipital interhemispheric) to the ambient cistern region provided similar exposure of anatomic structures. There was a significant difference (P < 0.05) in linear exposure of the posterior cerebral artery when comparing the ST/TC and ST/SC approaches. Conclusions This study has demonstrated that surgical approaches expose dissimilarly the different regions of the ambient cistern and an approach should be selected based on the specific need of anatomic exposure.

Publication Date

3-1-2016

Publication Title

World Neurosurgery

ISSN

18788750

E-ISSN

18788769

Volume

87

First Page

584

Last Page

590

PubMed ID

26547002

Digital Object Identifier (DOI)

10.1016/j.wneu.2015.10.063

This document is currently not available here.

Share

COinS