| Surgical indications and microsurgical anatomy of the transchoroidal fissure approach for lesions in and around the ambient cistern. | |
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MedLine Citation:
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PMID: 11950415 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Opening the temporal part of the choroidal fissure (CF) makes it possible to expose the crural cistern, the ambient cistern, and the medial temporal lobe. We examined the microsurgical anatomy and the surgical indications for use of the trans-CF approach. METHODS: The microsurgical anatomy encountered in the trans-CF approach for lesions in and around the ambient cistern was studied in three cadavers. On the basis of these cadaveric studies, the trans-CF approach was used during surgery in three live patients with such lesions. RESULTS: The angiographic "plexal point," which indicates the entrance of the anterior choroidal artery as it enters the temporal horn of the lateral ventricle, was thought to be a key anatomic landmark of the trans-CF approach. A cortical incision for entry into the temporal horn should be made in the inferior temporal gyrus to minimize the potential damage to the optic radiations and to the speech centers. After the CF is opened posteriorly to the plexal point between the tenia fimbria and the choroid plexus, the posterior cerebral artery (PCA) in the ambient cistern can be observed with minimal caudal retraction of the hippocampus. In this study, surgical procedures using the trans-CF approach were successfully performed on patients with high-positioned P2 aneurysms whose PCA ran close to the plexal point or higher, whose medial temporal arteriovenous malformations were fed mainly by the PCA, and whose tentorial hiatus meningiomas protruded into the temporal horn through the CF, with no resulting postoperative visual or memory disturbances. CONCLUSION: The trans-CF approach is especially useful in surgery for lesions in and around the ambient cistern. |
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Authors:
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Kiyonobu Ikeda; Katsuo Shoin; Masanao Mohri; Tamotsu Kijima; Shigeru Someya; Junkoh Yamashita |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 50 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 2002 May |
Date Detail:
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Created Date: 2002-04-12 Completed Date: 2002-06-28 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 1114-9; discussion 1120 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, National Kanazawa Hospital, Kanazawa, Japan. ikeda@kinbyou.hosp.go.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Arachnoid / surgery* Cadaver Central Nervous System Diseases / surgery* Cerebellar Neoplasms / diagnosis, surgery Cerebral Angiography Choroid Plexus / anatomy & histology*, surgery* Female Humans Intracranial Aneurysm / diagnosis, surgery Intracranial Arteriovenous Malformations / diagnosis, surgery Magnetic Resonance Imaging Meningeal Neoplasms / diagnosis, surgery Meningioma / diagnosis, surgery Middle Aged Neurosurgical Procedures / methods* Subarachnoid Space Temporal Lobe / surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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