The Anterolateral Limit of the Occipital Lobe: An Anatomical and Imaging Study.

 The boundaries of the temporal lobe, the parietal lobe, and the anterior portion of the occipital lobe (OL) are poorly defined. Lesions in these areas can be difficult to localize. Therefore, we studied the anterolateral limit of the OL to identify reliable anatomical landmarks.

Midline as a landmark for the position of the superior sagittal sinus on the cranial vault: An anatomical and imaging study.

Background: Craniotomies involving the midline are regular practice in neurosurgery, during which injury to the superior sagittal sinus (SSS), an uncommon yet devastating event, may occur. The midline tends to be the most common landmark used to identify the position of the SSS. In this study we examined the reliability of the midline as a landmark for the SSS.

The craniocaudal extension of posterolateral approaches and their combination: a quantitative anatomic and clinical analysis.

Objective: The aim of this study was to describe quantitatively the properties of the posterolateral approaches and their combination.

Methods: Six silicone-injected cadaveric heads were dissected bilaterally. Quantitative data were generated with the Optotrak 3020 system (Northern Digital, Waterloo, Canada) and Surgiscope (Elekta Instruments, Inc.

Supracerebellar infratentorial approach to cavernous malformations of the brainstem: surgical variants and clinical experience with 45 patients.

Objective: The supracerebellar infratentorial (SCIT) approach can be performed at the midline (median variant), lateral to the midline (paramedian variant), or at the level of the angle formed by the transverse and sigmoid sinuses (extreme lateral variant). We analyzed our experience with SCIT approaches for the surgical treatment of cavernous malformations of the brainstem (CMBs).

Methods: Demographic, clinical, radiologic, and surgical data from 45 patients (20 males and 25 females; mean age, 36.

The ascending pharyngeal artery and its relevance for neurosurgical and endovascular procedures.

Objective: The ascending pharyngeal artery (APA), a branch of the external carotid artery (ECA), supplies the lower cranial nerves, superior cervical ganglion, and nasopharyngeal structures. The APA can also supply blood to various intracranial lesions. We studied the anatomy of the APA in the context of its neurosurgical and endovascular relevance.

Anatomy of the superior ophthalmic vein approach for direct endovascular access to vascular lesions of the orbit and cavernous sinus.

Objective: The superior ophthalmic vein (SOV) provides an alternative venous access for the treatment of carotid-cavernous fistulae. Its direct surgical exposure and cannulation can be difficult. This study was performed to identify anatomic landmarks to facilitate localization and exposure of the SOV.

The accessory middle cerebral artery: anatomic report.

Objective: An accessory middle cerebral artery (MCA) usually originates between the A1 and proximal A2 segment of the anterior cerebral artery, reaches the sylvian fissure, and supplies the territory of the MCA. This anomaly has been associated with cerebral aneurysms and Moyamoya disease. We report an accessory MCA arising from the A2 segment.

Comparative study of cranial topographic procedures: Broca's legacy toward practical brain surgery.

Objective: In many locations, neurosurgeons still use stereotactic- or anatomic-based craniocerebral topography systems to identify cortical landmarks. However, their predictive value for identifying two key landmarks--the central sulcus (CS) and lateral sulcus (LS)--has never been evaluated. We quantitatively compare leading craniocerebral topographic methods and review their historical significance for neurosurgery.

Anatomy of the mastoid emissary vein and venous system of the posterior neck region: neurosurgical implications.

Objective: The superficial venous system of the posterior neck (suboccipital venous plexus) is a potential source of complications from bleeding and air embolism. Because there is little information available about this in the literature, an anatomic study of the superficial posterior neck venous system and a morphometric analysis of the mastoid emissary vein (MEV) complex were undertaken. Both surgical and endovascular implications were considered.

Moving toward the petroclival region: a model for quantitative and anatomical analysis of tumor shift.

Object: The authors quantitatively assessed the effects of balloon inflation as a model of tumor compression on the brainstem, cranial nerves, and clivus by measuring the working area, angle of attack, and brain shift associated with the retrosigmoid approach.

Methods: Six silicone-injected cadaveric heads were dissected bilaterally via the retrosigmoid approach. Quantitative data were generated, including key anatomical points on the skull base and brainstem.

Working area, safety zones, and angles of approach for posterior C-1 lateral mass screw placement: a quantitative anatomical and morphometric evaluation.

Object: The authors measured relevant quantitative anatomical parameters to define safety zones for the placement of C-1 posterior screws.

Methods: Nineteen linear, two angular, and four surface parameters of 20 dried atlantal specimens were evaluated. The Optotrak 3020 system was used to define the working area.

The history of neurosurgical procedures for moyamoya disease.

Almost 50 years of research on moyamoya disease (1957-2006) has led to the development of a variety of surgical and medical options for its management in affected patients. Some of these options have been abandoned, others have served as the basis for the development of better procedures, and many are still in use today. Investigators studying moyamoya disease during this period have concluded that the best treatment is planned after studying each patient's presenting symptoms and angiographic pattern.

Rudolf Ludwig Karl Virchow: pathologist, physician, anthropologist, and politician. Implications of his work for the understanding of cerebrovascular pathology and stroke.

The history of apoplexy and descriptions of stroke symptoms date back to ancient times. It was not until the mid-nineteenth century, however, that the contributions of Rudolf Ludwig Karl Virchow, including his descriptions of the phenomena he called "embolism" and "thrombosis" as well as the origins of ischemia, changed the understanding of stroke. He suggested three main factors that conduce to venous thrombosis, which are now known as the Virchow triad.

[Neurovascular structures of the posterior surface of the petrous pyramid: correlation with the approaches of the cerebellopontine angle].

A topographic study of posterior surface of the petrous pyramid was performed in 20 human cadaveri heads. The distances between the neurovascular structures were measured in the points where they contact the posterior surface of the petrous pyramid. The study also points out the relationship between the bone landmarks and the transverse and the superior petrous sinuses.

[Definition of the anterolateral occipital lobe limit in anatomical specimens and image examination].

The anterolateral limit of the occipital lobe was studied in anatomical specimens and with neuroimaging. Seven human cadaver heads, 103 normal CT-scan and 104 MRJ of the brain were studied. There was a fold of the dura mater on the transverse sinus (preoccipital tentorial plica) and a bony protuberance related directly to the preoccipital notch.