Topographic Classification of the Thalamus Surfaces Related to Microneurosurgery: A White Matter Fiber Microdissection Study.

Objective: To describe the topographic anatomy of surgically accessible surfaces of the human thalamus as a guide to surgical exploration of this sensitive area.

Methods: Using the operating microscope, we applied the fiber microdissection technique to study 10 brain specimens. Step-by-step dissections in superior-inferior, medial-lateral, and posterior-anterior directions were conducted to expose the surfaces and nuclei of the thalamus and to investigate the relevant anatomic relationships and visible connections.

The selective amygdalohippocampectomy for intractable temporal limbic seizures.

Object: The proximal (anterior) transsylvian approach through a pterional craniotomy was developed by the senior author (M.G.Y.

Surgical anatomy of supratentorial midline lesions.

Object: In this paper the authors correlate the surgical aspects of deep median and paramedian supratentorial lesions with the connective fiber systems of the white matter of the brain.

Methods: The cerebral hemispheres of 10 cadaveric brains were dissected in a mediolateral direction by using the fiber dissection technique, corresponding to the surgical approach.

Conclusions: This study illuminates the delicacy of the intertwined and stratified fiber laminae of the white matter, and establishes that these structures can be preserved at surgical exploration in patients.

Microsurgery for malignant gliomas.

Reflections directly involving the ongoing, intense research activities in biology, the neurosciences and in neurosurgery are discussed including the evolving diagnostic and treatment modalities of primary and secondary malignant gliomas of the central nervous system. The etiology of this enigmatic disease remains obscure, and a curative therapy is still not available. Nevertheless, as a result of changing paradigms in neuroanatomy, neuropathology, neurophysiology, neuroradiology and in neurosurgery, and taking into account the broader selection of adjuvant therapies available, well circumscribed malignant gliomas, which are in predilected compartments of the brain, can be efficiently resected.