Microsurgical Anatomy of Liliequist's Membrane

2003 ◽  
Vol 46 (3) ◽  
pp. 149-154 ◽  
Keyword(s):  
Microsurgical Anatomy ◽  
Liliequist’S Membrane

Microsurgical Anatomy of the Posterior Fossa Cisterns

Neurosurgery ◽  
1988 ◽  
Vol 23 (1) ◽  
pp. 58-80 ◽  
Author(s):  
Haruo Matsuno ◽  
Albert L. Rhoton ◽  
David Peace
Keyword(s):  
Posterior Fossa ◽  
Microsurgical Anatomy ◽  
Posterior Edge ◽  
Cisterna Magna ◽  
Lower Sheet ◽  
Vascular Structures ◽  
Liliequist’S Membrane ◽  
Oculomotor Nerves

ABSTRACT The microsurgical anatomy of the posterior fossa cisterns was examined in 15 cadavers using 3× to 40× magnification. Liliequist's membrane was found to split into two arachnoidal sheets as it spreads upward from the dorsum sellae: an upper sheet, called the diencephalic membrane, which attaches to the diencephalon at the posterior edge of the mamillary bodies, and a lower sheet, called the mesencephalic membrane, which attaches along the junction of the midbrain and pons. Several other arachnoidal membranes that separate the cisterns were identified. These include the anterior pontine membrane, which separates the prepontine and cerebellopontine cisterns; the lateral pontomesencephalic membrane, which separates the ambient and cerebellopontine cisterns; the medial pontomedullary membrane, which separates the premedullary and prepontine cisterns; and the lateral pontomedullary membrane, which separates the cerebellopontine and cerebellomedullary cisterns. The three cisterns in which the arachnoid trabeculae and membranes are the most dense and present the greatest obstacle at operation are the interpeduncular and quadrigeminal cisterns and the cisterna magna. Numerous arachnoid membranes were found to intersect the oculomotor nerves. The neural and vascular structures in each cistern are reviewed.

Microsurgical Anatomy of the Maxillary Artery and High Flow Bypass

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Osamu Akiyama ◽  
Satoshi Matsuo ◽  
Marcos Chiarullo ◽  
Abuzer Gungor ◽  
Albert Rhoton
Keyword(s):  
High Flow ◽  
Maxillary Artery ◽  
Microsurgical Anatomy

Microsurgical Anatomy of the Donor Arteries for Extracranial–Intracranial Bypass Surgery: An Anatomic and Radiologic Study

2019 ◽  
Author(s):  
Satoshi Matsuo ◽  
Noritaka Komune ◽  
Osamu Akiyama ◽  
Daisuke Hayashi ◽  
Toshiyuki Amano ◽  
...  
Keyword(s):  
Bypass Surgery ◽  
Microsurgical Anatomy ◽  
Radiologic Study

Microsurgical Anatomy of the Triangles of the Posterior Fossa: Neurosurgical Relevance

2020 ◽  
Author(s):  
Alejandro Monroy-Sosa ◽  
Srikant Chakravarthi ◽  
Jonathan Ortiz Rafael ◽  
Austin Epping ◽  
Richard Rovin ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Microsurgical Anatomy

Case report of 2 Carotid cave aneurysms: Microsurgical anatomy and technical pitfalls

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Bruno Camporeze ◽  
Marcus Vinicius de Morais ◽  
Roger Mathias ◽  
Stephanie Caroline Barbosa Bologna ◽  
Vinicius Oliveira Fernandes ◽  
...  
Keyword(s):  
Case Report ◽  
Microsurgical Anatomy

Microsurgical anatomy and treatment of dural defects in spontaneous spinal cerebrospinal fluid leaks

2020 ◽  
pp. 1-9
Author(s):  
Ako Matsuhashi ◽  
Keisuke Takai ◽  
Makoto Taniguchi
Keyword(s):  
Dura Mater ◽  
Fat Grafting ◽  
Thoracolumbar Junction ◽  
Microsurgical Anatomy ◽  
Dural Defect ◽  
Ct Myelography ◽  
Blood Patch ◽  
Neurosurgical Treatment ◽  
Dural Defects ◽  
Csf Leaks

OBJECTIVESpontaneous spinal CSF leaks are caused by abnormalities of the spinal dura mater. Although most cases are treated conservatively or with an epidural blood patch, some intractable cases require neurosurgical treatment. However, previous reports are limited to a small number of cases. Preoperative detection and localization of spinal dural defects are difficult, and surgical repair of these defects is technically challenging. The authors present the anatomical characteristics of dural defects and surgical techniques in treating spontaneous CSF leaks.METHODSAmong the consecutive patients who were diagnosed with spontaneous CSF leaks at the authors’ institution between 2010 and 2020, those who required neurosurgical treatment were included in the study. All patients’ clinical information, radiological studies, surgical notes, and outcomes were reviewed retrospectively. Outcomes of two different procedures in repairing dural defects were compared.RESULTSAmong 77 patients diagnosed with spontaneous CSF leaks, 21 patients (15 men; mean age 57 years) underwent neurosurgery. Dural defects were detected by FIESTA MRI in 7 patients, by CT myelography in 12, by digital subtraction myelography in 1, and by dynamic CT myelography in 1. The spinal levels of the defects were localized at the cervicothoracic junction in 16 patients (76%) and thoracolumbar junction in 4 (19%). Intraoperative findings revealed that the dural defects were small, circumscribed longitudinal slits located at the ventral aspect of the dura mater. The median dural defect size was 5 × 2 mm. The presence of dural defects at the thoracolumbar junction was associated with manifestation of an altered mental status, which was an unusual manifestation of CSF leaks (p = 0.003). Eight patients were treated via the posterior transdural approach with watertight primary sutures of the ventral defects, and 13 were treated with muscle or fat grafting. Regardless of the two different procedures, postoperative MRI showed either complete disappearance or significant reduction of the extradural CSF collection. No patient experienced postoperative neurological deficits. Clinical symptoms improved or stabilized in 20 patients with a median follow-up of 12 months.CONCLUSIONSDural defects in spontaneous CSF leaks were small, circumscribed longitudinal slits located ventral to the spinal cord at either the cervicothoracic or thoracolumbar junction. Muscle/fat grafting may be an alternative treatment to watertight primary sutures of ventral dural defects with a good outcome.

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