Skip to main content
Erschienen in: Neurosurgical Review 1/2021

08.02.2020 | Original Article

The ipsilateral interhemispheric transprecuneal approach: microsurgical anatomy, indications, and neurosurgical applications

verfasst von: Lorenzo Pescatori, Maria Pia Tropeano, Pasqualino Ciappetta

Erschienen in: Neurosurgical Review | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Surgical treatment of intraventricular lesions is challenging because of their deep location, vascularization, and their complex relationships with white matter fibers. The authors undertook this study to describe the microsurgical anatomy of the white matter fibers covering the lateral wall of the atrium and temporal horn and to demonstrate how the ipsilateral interhemispheric transprecuneal approach can be safely used to remove lesions of this region sparing the anatomo-functional integrity of the fibers themselves. A detailed description of the approach including operative measurements is also given. The Klingler’ technique with progressive identification of white matter fibers covering the lateral wall of the atrium and temporal horn was performed on ten formalin-fixed human hemispheres. Then, ten fresh, non-formalin-fixed non-silicon-injected adult cadaveric heads were analyzed for the simulation of the ipsilateral interhemispheric transprecuneal approach. Three illustrative cases are presented. The simulation of the interhemispheric transprecuneal approach on ten fresh non-formalin-fixed specimens showed that a 10 to 20 mm corticotomy perpendicular to the parieto-occipital sulcus at the junction with the cingulum allows a wide corridor for the exposure of the entire atrial cavity and the posterior third of the temporal horn. The ipsilateral interhemispheric transprecuneus approach represents a safe and effective option for tumors involving the atrium and the posterior third of the temporal horn.
Literatur
1.
Zurück zum Zitat Abosch A, McDermott MW, Wilson CB (2000) Lateral ventricular tumors. In: Kaye AH, Black PML (eds) Operative neurosurgery. Churchill Livingstone, New York, pp 799–812 Abosch A, McDermott MW, Wilson CB (2000) Lateral ventricular tumors. In: Kaye AH, Black PML (eds) Operative neurosurgery. Churchill Livingstone, New York, pp 799–812
2.
Zurück zum Zitat Amar AP, Ghosh S, Apuzzo MLJ (2004) Ventricular tumors. In: Winn HR (ed) Youmans neurological surgery. WB Saunders, Philadelphia, pp 1237–1263 Amar AP, Ghosh S, Apuzzo MLJ (2004) Ventricular tumors. In: Winn HR (ed) Youmans neurological surgery. WB Saunders, Philadelphia, pp 1237–1263
3.
Zurück zum Zitat Barrow DL, Dawson R (1994) Surgical management of arteriovenous malformations in the region of the ventricular trigone. Neurosurgery 35:1046–1054CrossRef Barrow DL, Dawson R (1994) Surgical management of arteriovenous malformations in the region of the ventricular trigone. Neurosurgery 35:1046–1054CrossRef
4.
Zurück zum Zitat Batjer H, Samson DS (1987) Surgical approaches to trigonal arteriovenous malformations. J Neurosurg 67:511–517CrossRef Batjer H, Samson DS (1987) Surgical approaches to trigonal arteriovenous malformations. J Neurosurg 67:511–517CrossRef
5.
Zurück zum Zitat Campero A, Tróccoli G, Martins C, Fernandez-Miranda JC, Yasuda A, Rhoton AL Jr (2006) Microsurgical approaches to the medial temporal region: an anatomical study. Neurosurgery. 59(4 Suppl 2):ONS279–ONS307PubMed Campero A, Tróccoli G, Martins C, Fernandez-Miranda JC, Yasuda A, Rhoton AL Jr (2006) Microsurgical approaches to the medial temporal region: an anatomical study. Neurosurgery. 59(4 Suppl 2):ONS279–ONS307PubMed
6.
Zurück zum Zitat Charalampaki P, Filippi R, Welschehold S, Conrad J, Perneczky A (2005) Tumors of the lateral and third ventricle: removal under endoscope-assisted keyhole conditions. Neurosurgery 57:302–311PubMed Charalampaki P, Filippi R, Welschehold S, Conrad J, Perneczky A (2005) Tumors of the lateral and third ventricle: removal under endoscope-assisted keyhole conditions. Neurosurgery 57:302–311PubMed
7.
Zurück zum Zitat Ciappetta P, Pescatori L (2017) Anatomic dissection of arachnoid membranes encircling the pituitary stalk on fresh, non-formalin-fixed specimens: anatomoradiologic correlations and clinical applications in craniopharyngioma surgery. World Neurosurg. 108:479–490CrossRef Ciappetta P, Pescatori L (2017) Anatomic dissection of arachnoid membranes encircling the pituitary stalk on fresh, non-formalin-fixed specimens: anatomoradiologic correlations and clinical applications in craniopharyngioma surgery. World Neurosurg. 108:479–490CrossRef
8.
Zurück zum Zitat Coppens JR, Mahaney KB, Abdulrauf SI (2005) An anteromedial approach to the temporal horn to avoid injury to the optic radiation fibers and uncinate fasciculus: anatomical and technical note. Neurosurg Focus 18:E3CrossRef Coppens JR, Mahaney KB, Abdulrauf SI (2005) An anteromedial approach to the temporal horn to avoid injury to the optic radiation fibers and uncinate fasciculus: anatomical and technical note. Neurosurg Focus 18:E3CrossRef
9.
Zurück zum Zitat D’Angelo VA, Galarza M, Catapano D, Monte V, Bisceglia M, Carosi I (2005) Lateral ventricle tumors: surgical strategies according to tumor origin and development—Aseries of 72 cases. Neurosurgery 56:36–45CrossRef D’Angelo VA, Galarza M, Catapano D, Monte V, Bisceglia M, Carosi I (2005) Lateral ventricle tumors: surgical strategies according to tumor origin and development—Aseries of 72 cases. Neurosurgery 56:36–45CrossRef
10.
Zurück zum Zitat Fernández-Miranda JC, Rhoton AL Jr, AlvarezLinera J, Kakizawa Y, Choi C, de Oliveira EP (2008) Three-dimensional microsurgical and tractographic anatomy of the white matter of the human brain. Neurosurgery. 62:989–1028CrossRef Fernández-Miranda JC, Rhoton AL Jr, AlvarezLinera J, Kakizawa Y, Choi C, de Oliveira EP (2008) Three-dimensional microsurgical and tractographic anatomy of the white matter of the human brain. Neurosurgery. 62:989–1028CrossRef
11.
Zurück zum Zitat Fornari M, Savoiardo M, Morello G, Solero CL (1981) Meningiomas of the lateral ventricles: neuroradiological and surgical considerations in 18 cases. J Neurosurg 54:64–74CrossRef Fornari M, Savoiardo M, Morello G, Solero CL (1981) Meningiomas of the lateral ventricles: neuroradiological and surgical considerations in 18 cases. J Neurosurg 54:64–74CrossRef
12.
Zurück zum Zitat Guidetti B, Delfini R, Gagliardi FM, Vagnozzi R (1985) Meningiomas of the lateral ventricles: clinical, neuroradiologic, and surgical considerations in 19 cases. Surg Neurol 24:364–370CrossRef Guidetti B, Delfini R, Gagliardi FM, Vagnozzi R (1985) Meningiomas of the lateral ventricles: clinical, neuroradiologic, and surgical considerations in 19 cases. Surg Neurol 24:364–370CrossRef
13.
Zurück zum Zitat Jun CL, Nutik SL (1985) Surgical approaches to intraventricular meningiomas of the trigone. Neurosurgery 16:416–420CrossRef Jun CL, Nutik SL (1985) Surgical approaches to intraventricular meningiomas of the trigone. Neurosurgery 16:416–420CrossRef
14.
Zurück zum Zitat Kawashima M, Li X, Rhoton AL Jr, Ulm AJ, Oka H, Fujii K (2006) Surgical approaches to the atrium of the lateral ventricle: microsurgical anatomy. Surg Neurol 65:436–445CrossRef Kawashima M, Li X, Rhoton AL Jr, Ulm AJ, Oka H, Fujii K (2006) Surgical approaches to the atrium of the lateral ventricle: microsurgical anatomy. Surg Neurol 65:436–445CrossRef
15.
Zurück zum Zitat Lawton MT, Golfinos JG, Spetzler RF (1996) The contralateral transcallosal approach: experience with 32 patients. Neurosurgery 39:729–735CrossRef Lawton MT, Golfinos JG, Spetzler RF (1996) The contralateral transcallosal approach: experience with 32 patients. Neurosurgery 39:729–735CrossRef
16.
Zurück zum Zitat Nagata S, Sasaki T (2005) Lateral transsulcal approach to asymptomatic trigonal meningiomas with correlative microsurgical anatomy: technical case report. Neurosurgery 56:E438PubMed Nagata S, Sasaki T (2005) Lateral transsulcal approach to asymptomatic trigonal meningiomas with correlative microsurgical anatomy: technical case report. Neurosurgery 56:E438PubMed
17.
Zurück zum Zitat Pendl G, Oztürk E, Haselsberger K (1992) Surgery of tumours of the lateral ventricle. 116(2-4):128–36 Pendl G, Oztürk E, Haselsberger K (1992) Surgery of tumours of the lateral ventricle. 116(2-4):128–36
18.
Zurück zum Zitat Pescatori L, Tropeano MP, Manfreda A, Delfini R, Santoro A (2017) Three-dimensional anatomy of the white matter fibers of the temporal lobe: surgical implications. World Neurosurg 100:144–158CrossRef Pescatori L, Tropeano MP, Manfreda A, Delfini R, Santoro A (2017) Three-dimensional anatomy of the white matter fibers of the temporal lobe: surgical implications. World Neurosurg 100:144–158CrossRef
19.
Zurück zum Zitat Pescatori L, Tropeano MP, Ciappetta P (2018) Meckel’s cave meningiomas: new classification system focalized on dumbbell lesions deriving from the morphometric analysis of the posterior petrous apicectomy on fresh non-formalin-fixed specimens. A Correlative Anatomoclinical Study. World Neurosurg 118:e489–e499CrossRef Pescatori L, Tropeano MP, Ciappetta P (2018) Meckel’s cave meningiomas: new classification system focalized on dumbbell lesions deriving from the morphometric analysis of the posterior petrous apicectomy on fresh non-formalin-fixed specimens. A Correlative Anatomoclinical Study. World Neurosurg 118:e489–e499CrossRef
20.
Zurück zum Zitat Piepmeier JM, Westerveld M, Spencer DD, Sass KJ (1995) Surgical management of intraventricular tumors of the lateral ventricles. In: Schmidek HH, Sweet WH (eds) Operative neurosurgical techniques: indications, methods, and results. WB Saunders, Philadelphia, pp 725–738 Piepmeier JM, Westerveld M, Spencer DD, Sass KJ (1995) Surgical management of intraventricular tumors of the lateral ventricles. In: Schmidek HH, Sweet WH (eds) Operative neurosurgical techniques: indications, methods, and results. WB Saunders, Philadelphia, pp 725–738
21.
Zurück zum Zitat Rhoton AL Jr (2002) The lateral and third ventricles. Neurosurgery 51:S207–S271PubMed Rhoton AL Jr (2002) The lateral and third ventricles. Neurosurgery 51:S207–S271PubMed
22.
Zurück zum Zitat Sincoff EH, Tan Y, Abdulrauf SI (2004) White matter fiber dissection of the optic radiations of the temporal lobe and implications for surgical approaches to the temporal horn. J Neurosurg 101:739–746CrossRef Sincoff EH, Tan Y, Abdulrauf SI (2004) White matter fiber dissection of the optic radiations of the temporal lobe and implications for surgical approaches to the temporal horn. J Neurosurg 101:739–746CrossRef
23.
Zurück zum Zitat Türe U, Harput MV, Kaya AH, Baimedi P, Firat Z, Türe H, Bingöl CA (2012) The paramedian supracerebellar-transtentorial approach to the entire length of the mediobasal temporal region: an anatomical and clinical study. Laboratory investigation. J Neurosurg 116(4):773–791CrossRef Türe U, Harput MV, Kaya AH, Baimedi P, Firat Z, Türe H, Bingöl CA (2012) The paramedian supracerebellar-transtentorial approach to the entire length of the mediobasal temporal region: an anatomical and clinical study. Laboratory investigation. J Neurosurg 116(4):773–791CrossRef
24.
Zurück zum Zitat Türe U, Yasargil MG, Friedman AH, Al-Mefty O (2000) Fiber dissection technique: lateral aspect of the brain. Neurosurgery 47:417–427CrossRef Türe U, Yasargil MG, Friedman AH, Al-Mefty O (2000) Fiber dissection technique: lateral aspect of the brain. Neurosurgery 47:417–427CrossRef
25.
Zurück zum Zitat Wang S, Salma A, Ammirati M (2010) Posterior interhemispheric transfalx transprecuneus approach to the atrium of the lateral ventricle: a cadaveric study. J Neurosurg 113(5):949–954CrossRef Wang S, Salma A, Ammirati M (2010) Posterior interhemispheric transfalx transprecuneus approach to the atrium of the lateral ventricle: a cadaveric study. J Neurosurg 113(5):949–954CrossRef
26.
Zurück zum Zitat Wen HT, Rhoton AL Jr, de Oliveira E, Cardoso AC, Tedeschi H, Baccanelli M et al (1999) Microsurgical anatomy of the temporal lobe: part 1: mesial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy. Neurosurgery. 45:549–592CrossRef Wen HT, Rhoton AL Jr, de Oliveira E, Cardoso AC, Tedeschi H, Baccanelli M et al (1999) Microsurgical anatomy of the temporal lobe: part 1: mesial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy. Neurosurgery. 45:549–592CrossRef
27.
Zurück zum Zitat Wen HT, Rhoton AL Jr, de Oliveira E, Castro LH, Figueiredo EG, Teixeira MJ (2009) Microsurgical anatomy of the temporal lobe: part 2-Sylvian fissure region and its clinical application. Neurosurgery. 65:1–35CrossRef Wen HT, Rhoton AL Jr, de Oliveira E, Castro LH, Figueiredo EG, Teixeira MJ (2009) Microsurgical anatomy of the temporal lobe: part 2-Sylvian fissure region and its clinical application. Neurosurgery. 65:1–35CrossRef
28.
Zurück zum Zitat Xie T, Sun C, Zhang X, Zhu W, Zhang J, Gu Y, Li W (2015) The contralateral transfalcine transprecuneus approach to the atrium of the lateral ventricle: operative technique and surgical results. Neurosurgery. 11(Suppl 2):110–117PubMed Xie T, Sun C, Zhang X, Zhu W, Zhang J, Gu Y, Li W (2015) The contralateral transfalcine transprecuneus approach to the atrium of the lateral ventricle: operative technique and surgical results. Neurosurgery. 11(Suppl 2):110–117PubMed
Metadaten
Titel
The ipsilateral interhemispheric transprecuneal approach: microsurgical anatomy, indications, and neurosurgical applications
verfasst von
Lorenzo Pescatori
Maria Pia Tropeano
Pasqualino Ciappetta
Publikationsdatum
08.02.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Neurosurgical Review / Ausgabe 1/2021
Print ISSN: 0344-5607
Elektronische ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-020-01244-z

Weitere Artikel der Ausgabe 1/2021

Neurosurgical Review 1/2021 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.