Transanterior Limiting Sulcus of the Insula Approach: Novel Surgical Approach to the Ventral Striatum Region.

Background: Lesions in the ventral striatum region (above the anterior perforated substance) are a challenge for neurosurgeons due to their direct relationship with the lenticulostriate arteries, which difficult the surgical access. The standard approaches for this region include the following: 1) transfrontal approach, 2) transanterior perforating substance approach, 3) transcallosal transventricular approach, and 4) pterional transsylvian-transinsular route. In this study, we aimed to describe a novel anatomical approach through the anterior limiting sulcus of the insula in order to access the ventral striatum.

Interpeduncular Sulcus Approach to the Posterolateral Pons.

Objective: In this article, we describe a new safe entry point for the posterolateral pons.

Methods: To show the adjacent anatomy and measure the part of the interpeduncular sulcus that can be safely accessed, we first performed a review of the literature regarding the pons anatomy and its surgical approaches. Thereafter, 1 human cadaveric head and 15 (30 sides) human brainstems with attached cerebellums were bilaterally dissected with the fiber microdissection technique.

Posterior Cerebral Artery Aneurysms: Treatment and Outcome Analysis in 121 Patients.

Objective: Aneurysms of the posterior cerebral artery (PCA) are uncommon. Because of their low incidence, only 5 series with more than 30 patient cases have been reported. The treatment of PCA aneurysms is challenging because of the high frequency of fusiform aneurysms and closeness to important neuroanatomic structures.

Microsurgical anatomy and internal architecture of the brainstem in 3D images: surgical considerations.

OBJECT Brainstem surgery remains a challenge for the neurosurgeon despite recent improvements in neuroimaging, microsurgical techniques, and electrophysiological monitoring. A detailed knowledge of the microsurgical anatomy of the brainstem surface and its internal architecture is mandatory to plan appropriate approaches to the brainstem, to choose the safest point of entry, and to avoid potential surgical complications. METHODS An extensive review of the literature was performed regarding the brainstem surgical approaches, and their correlations with the pertinent anatomy were studied and illustrated through dissection of human brainstems properly fixed with 10% formalin.

Microsurgical anatomy of the optic radiation and related fibers in 3-dimensional images.

Background: The fiber dissection technique provides unique 3-dimensional anatomic knowledge of the white matter.

Objective: To examine the optic radiation anatomy and its important relationship with the temporal stem and to discuss its findings in relation to the approaches to temporal lobe lesions.

Methods: We studied 40 cerebral hemispheres of 20 brains that had been fixed in formalin solution for 40 days.

Supracerebellar transtentorial approach-resection of the tentorium instead of an opening-to provide broad exposure of the mediobasal temporal lobe: anatomical aspects and surgical applications: clinical article.

Object: The aim of this study was to describe the surgical anatomy of the mediobasal aspect of the temporal lobe and the supracerebellar transtentorial (SCTT) approach performed not with an opening, but with the resection of the tentorium, as an alternative route for the neurosurgical management of vascular and tumoral lesions arising from this region.

Methods: Cadaveric specimens were used to illustrate the surgical anatomy of the mediobasal region of the temporal lobe. Demographic aspects, characteristics of lesions, clinical presentation, surgical results, follow-up findings, and outcomes were retrospectively reviewed for patients referred to receive the SCTT approach with tentorial resection.

Microsurgical anatomy of the posterior cerebral artery in three-dimensional images.

Objective: To describe the microsurgical anatomy, branches, and anatomic relationships of the posterior cerebral artery (PCA) represented in three-dimensional images.

Methods: Seventy hemispheres of 35 brain specimens were studied. They were previously injected with red silicone and fixed in 10% formalin for at least 40 days.