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Surgical and Radiologic Anatomy

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14.06.2021 | Anatomic Bases of Medical, Radiological and Surgical Techniques

Neurosurgical anatomy of the floor of the third ventricle and related vascular structures

verfasst von: João Fernandes-Silva, Susana M. Silva, Hélio Alves, José P. Andrade, Mavilde Arantes

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 12/2021

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Abstract

Purpose

Anatomical knowledge of the floor of the third ventricle (FTV) is essential in avoiding surgical complications during endoscopic third ventriculostomy. The purpose of this study was to characterize the morphometry of FTV and related arteries, particularly the basilar artery (BA), as well as the factors that influence it.

Methods

Twenty-six formalin-fixed adult brains and two hundred adult brain MRIs were studied focusing on FTV and related arteries. Dimensions of interest were measured using image analysis software. Morphometric data obtained were statistically analysed.

Results

Distances between FTV, intermammillary sulcus (IMS), infundibulum, BA bifurcation, and posterior communicating arteries (PCoAs) were described on the cadavers and the MRIs. Distance between right and left PCoAs was greater at their anterior extremity (p < 0.001). Right PCoA was longer (p = 0.016). BA was lateralized in 58.4% of cases and its calibre was larger in males (p < 0.001). The distance from BA apex to FTV was inversely correlated with BA diameter (p < 0.001) and age (p = 0.004). Distance from IMS to infundibulum and the distance between both PCoAs were greater in MRI series when compared to cadaver series (p < 0.001).

Conclusions

A quantitative description of the morphometry of the region of the FTV and related vessels was obtained, helping neurosurgeons in planning their surgical approach. The distance from BA apex to FTV was shorter in individuals with larger BA calibre and in older subjects. MRI studies were qualitatively superior to cadaveric studies in evaluating the anatomy of this region.

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Titel: Neurosurgical anatomy of the floor of the third ventricle and related vascular structures
verfasst von: João Fernandes-Silva
Susana M. Silva
Hélio Alves
José P. Andrade
Mavilde Arantes
Publikationsdatum: 14.06.2021
Verlag: Springer Paris
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 12/2021
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-021-02785-8

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Neurosurgical anatomy of the floor of the third ventricle and related vascular structures