The lateral cerebral peduncle approach to ventrally placed intra-axial midbrain tumors: A technical note
| Autor: | Abhidha Shah, Atul Goel, Sukhdeep Singh Jhawar |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Microsurgery Cerebral Peduncle Schwannoma Midbrain Young Adult 03 medical and health sciences 0302 clinical medicine Cadaver Physiology (medical) Brain Stem Neoplasms Humans Medicine Interpeduncular cistern business.industry Cerebral peduncle General Medicine Anatomy Sulcus medicine.disease Dissection medicine.anatomical_structure Neurology 030220 oncology & carcinogenesis Female Surgery Neurology (clinical) Brainstem business Craniotomy 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Neuroscience. 89:226-231 |
| ISSN: | 0967-5868 |
| Popis: | We describe the anatomical landmarks and surgical feasibility of a novel ‘safe’ brainstem entry zone to approach ventrally placed intra-axial midbrain tumors. The anatomy of the brainstem was specifically studied to evaluate safe surgical entry zone in the midbrain on two formalin fixed silicon injected cadaver head specimens. A novel entry point through the lateral one – fifth of the cerebral peduncle was identified to be ‘safe’ to approach lesions of the ventral midbrain. Three patients, having oculomotor schwannoma, peduncular glioma and a peduncular cavernoma were operated using this safe entry zone. To approach the midbrain, retrosigmoid lateral supracerebellar route was used in two patients and a basal subtemporal avenue was deployed in one patient. On the basis of fine microanatomical dissection on cadavers, a novel entry point through the lateral one-fifth of the cerebral peduncle, 5 mm anterior to the lateral mesencephalic sulcus and approximately 5 mm superior to the fourth nerve was identified. The proposed brainstem entry point traverses the parieto-temporo-occipital pontine fibers and the trajectory is between the corticospinal tracts ventrally and the substantia nigra dorsally. Three patients were operated successfully using the approach. There were no post-operative motor, sensory or extra-pyramidal deficits. The corridor through the lateral one-fifth of the cerebral peduncle presents a safe and relative ‘easy’ surgical route to approach ventrally placed intra-axial midbrain tumors. |
| Databáze: | OpenAIRE |
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