Microanatomical study of the choroidal fissure in ventricular and cisternal approaches

The choroidal fissure is a narrow cleft in the medial part of the lateral ventricle, in a C-shaped arc, between the fornix and the thalamus, where the choroidal plexus join. Due to absence nervous tissue between ependima and pia-mater along this invagination, it is an important route in brain ventricles and cisterns. Five brains were studied by injecting colored silicone arteries and veins and five brains without colored silicone, in a total number of 20 brain hemispheres. it was analized and revised the neural, arterial and venous relationships and surgical approaches in all parts of the choroidal fissure, In conclusion, the previous knowledge detailed this microanatomy is primordial for neurosurgeons that will approach brain ventricular and cisternal lesions because the neurosurgeons gain a tridimensional notion that will be indispensable during surgery.633B80180

Microsurgical anatomy of the cavernous sinus: Measurements of the triangles in and around it

Objectives: Since the pioneering work of Parkinson, several studies have described the microsurgical anatomy and surgical procedures involving the cavernous sinus (CS). A proposed geometric construct has been adopted as nomenclature for the region by many neurosurgeons. However, authors differ in naming and describing some of these triangular spaces. The purpose of this study is to present the anatomy and measure the dimensions of the 10 triangles in and around this region. Materials and Methods: Eighteen CS of five cadaveric heads and four skull bases fixed in formalin were dissected using 3 x to 40 x magnification of the surgical microscope. The heads and skull bases were injected with colored silicone and the sides and area of the triangles were measured. Each cadaveric head was placed in a Sugita head-holder and a cranio-orbitozygomatic approach and a combined extra- and intradural approach were performed. The last step was the detachment of the brain from the skull base and measurement of the inferolateral paraclival and inferomedial paraclival triangles. Results: The measurements of the medial border, lateral border, and base of each triangle as well as the standard deviation and area are presented. The posteromedial middle fossa triangle was the largest and the clinoidal triangle the smallest. Conclusions: The normal anatomy of the CS triangle and its areas are important in the approach of the CS lesions because these spaces are natural corridors through which the lesions can be reached. The same concept must be used for the triangles around this space. Whenever these geometric spaces might be distorted by pathology or surgical maneuvers, the surgeon must have precise knowledge about their normal sizes.o TEXTO COMPLETO DESTE ARTIGO, ESTARÁ DISPONÍVEL À PARTIR DE AGOSTO DE 2015.17635736