Surgical Anatomy of the Subcallosal Artery: Implications for Transcranial and Endoscopic Endonasal Surgery in the Suprachiasmatic Region
| Autor: | Huy Q. Truong, Paul A. Gardner, Joao Tiago A. Belo, Edinson Najera, Juan C. Fernandez-Miranda |
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| Rok vydání: | 2018 |
| Předmět: |
Adenoma
Adult Male Microsurgery Communicating Artery Endoscopic endonasal surgery Prefrontal Cortex Splenium Corpus callosum 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine.artery Cadaver Humans Medicine Pituitary Neoplasms Lamina terminalis business.industry Intracranial Aneurysm Anatomy Cerebral Arteries Middle Aged Subcallosal area Anterior communicating artery medicine.anatomical_structure Neuroendoscopy Female Surgery Neurology (clinical) Meningioma business 030217 neurology & neurosurgery Artery |
| Zdroj: | Operative Neurosurgery. 17:79-87 |
| ISSN: | 2332-4260 2332-4252 |
| DOI: | 10.1093/ons/opy276 |
| Popis: | Background Suprachiasmatic subcallosal lesions may have an intimate relationship with the anterior communicating artery (AcomA); injury to AcomA branches can result in basal forebrain infarction and cognitive dysfunction. Objective To evaluate anatomic variations of the AcomA basal perforating branches, especially the subcallosal artery (ScA), for clinical implications when approaching the suprachiasmatic subcallosal region from endonasal and transcranial routes. Methods The origin, course, diameter, and branching pattern of the AcomA's perforating branches were studied in 33 specimens from transcranial and endonasal perspectives. Results The ScA was present in 79% of the specimens as a single dominant artery arising from the posterior/posterosuperior surface of the AcomA, along with hypothalamic arteries (55%), or as a single artery (24%). It coursed posteriorly towards the lamina terminalis region, curving superiorly to the subcallosal area. The ScA gave off many branches to provide the main blood supply to the subcallosal region. Importantly, it supplies the septal/subcallosal region bilaterally. The ScA can be found posterior, superior, or inferior to the AcomA when using a transylvian, interhemispheric, or endonasal approach, respectively. In specimens with no ScA (21%), the median callosal artery (MdCA) was the dominant artery arising from the AcomA. It followed an identical course to the ScA, providing supply to the same structures bilaterally, but its distal extension reached the body/splenium of the corpus callosum. The MdCA is a ScA variant. Conclusion The ScA is a unique vessel because it supplies the septal/subcallosal region bilaterally; preservation of this vessel during surgery is crucial for successful outcomes. |
| Databáze: | OpenAIRE |
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