Microsurgical Anatomy of the Posterior Cerebral Artery in Three-Dimensional Images

Abstract The vascular microsurgical anatomy in the area of the basilar artery bifurcation is described in 30 autopsy dissections. Particular emphasis is placed on variations of the posterior thalamoperforators and their relation to the proximal posterior cerebral artery and basilar bifurcation.

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Microsurgical Anatomy and Quantitative Analysis of the Transtemporal-Transchoroidal Fissure Approach to the Ambient Cistern

Operative Neurosurgery ◽

10.1227/01.neu.0000176407.35946.88 ◽

2005 ◽

Vol 57 (suppl_4) ◽

pp. ONS-228-ONS-235 ◽

Cited By ~ 6

Author(s):

Rungsak Siwanuwatn ◽

Pushpa Deshmukh ◽

Joseph M. Zabramski ◽

Mark C. Preul ◽

Robert F. Spetzler

Keyword(s):

Quantitative Analysis ◽

Temporal Lobe ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Vascular Anatomy ◽

Venous Drainage ◽

Preoperative Imaging ◽

Surgical Approaches ◽

Microsurgical Anatomy ◽

Ambient Cistern

Abstract OBJECTIVE: Surgical approaches to ambient cistern lesions are complex. We investigated the microanatomy of the transtemporal-transchoroidal fissure approach to the ambient cistern with emphasis on exposure of the posterior cerebral artery. METHODS: Dissections were performed bilaterally in five silicone-injected cadaveric heads. Critical anatomic distances, specifically with reference to the P2 segment of posterior cerebral artery in relation to the inferior choroidal point and P2–P3 junction, were measured with digital calipers. Other landmarks (temporal lobe tip, points from the temporal base to the choroidal fissure) were included for quantitative analysis. RESULTS: The transtemporal-transchoroidal fissure approach provided adequate exposure of the ambient cistern, minimized temporal lobe retraction, and allowed assessment of regional microanatomy. The mean distance from the temporal base to the choroidal fissure measured 18.09 mm (range, 16.9–21.9 mm). The distances from the choroidal fissure to P2 varied at the coronal plane of the inferior choroidal point (mean, 6.96 mm; range, 3.6–12.0 mm) and the P2–P3 junction (mean, 6.02 mm; range, 4.3–6.9 mm), respectively. CONCLUSION: The transtemporal-transchoroidal fissure approach provides a corridor to the ambient cistern and P2–P3 junction while minimizing temporal lobe retraction and avoiding interruption of temporal lobe venous drainage. Because of widely variable vascular anatomy, access to posterior cerebral artery lesions using this approach requires preoperative imaging to identify the specific location of the P2–P3 junction.

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The Thalamogeniculate Perforators of the Posterior Cerebral Artery: The Microsurgical Anatomy

Neurosurgery ◽

10.1227/00006123-199104000-00007 ◽

1991 ◽

Vol 28 (4) ◽

pp. 523-530 ◽

Cited By ~ 36

Author(s):

Milan M. Milisavljević ◽

Slobodan V. Marinković ◽

Hirohiko Gibo ◽

Laslo F. Puškaš

Keyword(s):

Superior Colliculus ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Medial Geniculate Body ◽

Lateral Geniculate Body ◽

Distal Segment ◽

Microsurgical Anatomy ◽

Lateral Geniculate ◽

Medial Geniculate ◽

The Common

Abstract The thalamogeniculate (TG); arteries of 30 forebrain hemispheres were examined. These vessels varied from 2 to 12 in number (mean, 5.7);, and from 70 to 580 μm in caliber (mean, 345.8 μm);. The average caliber of all the TG vessels per posterior cerebral artery ranged from 700 to 3400 μm (mean, 1972 μm);. The TG arteries most often originated as individual vessels; however, in 26.67% of the hemispheres examined they shared a common site of origin, and 33.33% of the hemispheres they arose from common stems. The common stems ranged from 320 to 800 μm in diameter (mean, 583 μm);. The TG branches arose from the crural or ambient (P2); segment of the posterior cerebral artery in 80% of the hemispheres, from the P2 and the quadrigeminal (P3); segment in 20%, from both the distal segment of the posterior cerebral artery and the common temporal artery (13.33%);, or from the distal segment and either the calcarine (3.33%); or parieto-occipital artery (3.33%);. The TG arteries usually penetrated the medial geniculate body (100%);, pulvinar thalami (80%);, brachium of the superior colliculus (53.33%);, or lateral geniculate body (13.33%);. The collateral branches of the TG arteries were noted to reach the medial geniculate body (76.67%);, pulvinar (70%);, brachium of the superior colliculus (40%);, crus cerebri (40%);, and lateral geniculate body (6.67%);. The anastomoses were present in 66.67%, usually between the TG vessels and the medial posterior choroidal artery (33.33%);, or the mesencephalothalamic artery (26.67%);. They ranged in number from 1 to 3 (mean, 1.2);, and in caliber from 90 to 400 μm (mean, 197 μm);. In spite of the anastomoses, the TG arteries must be spared during surgery within the ambient cistern.

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The posterior thalamoperforating artery (the main perforating trunk from P1) microsurgical study

JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA ◽

10.22290/jbnc.v3i4.77 ◽

2017 ◽

Vol 3 (4) ◽

pp. 103-107

Author(s):

Aziz Rassi Neto ◽

Ápio Cláudio Martins Antunes ◽

Fernando Menezes Braga

Keyword(s):

Cerebral Artery ◽

Basilar Artery ◽

Posterior Cerebral Artery ◽

Neurosurgical Procedures ◽

Microsurgical Anatomy ◽

Deep Knowledge ◽

The Mean ◽

Human Brains

Thirty fresh human brains were studied regarding to the anatomy of the posterior thalamoperforating arteries (PThPA): origin, number, diameter, traject, distance from the basilar artery bifurcation, type of distribution and correspondent area of vascularization. Most of the PThPAs originated proximally in the posterior cerebral artery (PCA), irrigating the cerebral, peduncles, mammilary bodies, ventral portion of midbrain and, through the posterior perforated substance, the medial portion of thalamus. The mean number of PThPAs per hemisphere was 1.51, mean proximal diameter 0.60 mm and mean distance from PCA origin 2.47 mm. A deep knowledge of the microsurgical anatomy of PThPAs is stressed, as devastating lesions can develop after arterial compromise during neurosurgical procedures.

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The Usefulness of the New “Double-Catheter Technique” in the Treatment of Parent Artery Incorporated Wide-Necked Aneurysm with Guglielmi Detachable Coils

Interventional Neuroradiology ◽

10.1177/159101990000600107 ◽

2000 ◽

Vol 6 (1) ◽

pp. 61-64 ◽

Cited By ~ 6

Author(s):

Yong Sam Shin ◽

Dong-Ik Kim ◽

Seung Ik Lee ◽

Jin Il Chung ◽

Pyeong Ho Yoon ◽

...

Keyword(s):

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Three Dimensional ◽

Parent Artery ◽

Guglielmi Detachable Coils ◽

Viable Option ◽

Catheter Technique ◽

Detachable Coils ◽

The Right ◽

Grade Iii

We describe a technique used to treat a wide-necked aneurysm in which the neck is incorporated with the parent artery. The patient was a 54-year-old woman who had suffered a grade III subarachnoid haemorrhage. Angiogram and three-dimensional CT showed a large, wide-necked aneurysm of the basilar bifurcation area with the right posterior cerebral artery incorporated in the aneurysm sac. A microcatheter was placed in the right posterior cerebral artery (PCA). Another catheter was placed within the aneurysm lumen. When making a first frame with a GDC, we made sure that the frame of the coil did not overlap the PCA positioned microcatheter. Then, with the microcatheter positioned at the PCA, the angiogram was done. The flow pattern and dye-disappearance time were checked. Subsequent coils were introduced, but not beyond the frame of the first coil to maintain PCA flow. This new “double-catheter technique” represents a viable option for treating wide-necked aneurysms, especially when the parent artery is incorporated in a wide-necked aneurysm and the delineation of the parent artery is impossible.

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X-ray microtomography

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100107058 ◽

1988 ◽

Vol 46 ◽

pp. 998-999

Author(s):

H.W. Deckman ◽

B.F. Flannery ◽

J.H. Dunsmuir ◽

K.D' Amico

Keyword(s):

Computed Tomography ◽

Internal Structure ◽

Imaging Technique ◽

Three Dimensional ◽

Tissue Structure ◽

Individual Element ◽

X Ray ◽

Non Invasive ◽

Panoramic Imaging ◽

Three Dimensional Images

We have developed a new X-ray microscope which produces complete three dimensional images of samples. The microscope operates by performing X-ray tomography with unprecedented resolution. Tomography is a non-invasive imaging technique that creates maps of the internal structure of samples from measurement of the attenuation of penetrating radiation. As conventionally practiced in medical Computed Tomography (CT), radiologists produce maps of bone and tissue structure in several planar sections that reveal features with 1mm resolution and 1% contrast. Microtomography extends the capability of CT in several ways. First, the resolution which approaches one micron, is one thousand times higher than that of the medical CT. Second, our approach acquires and analyses the data in a panoramic imaging format that directly produces three-dimensional maps in a series of contiguous stacked planes. Typical maps available today consist of three hundred planar sections each containing 512x512 pixels. Finally, and perhaps of most import scientifically, microtomography using a synchrotron X-ray source, allows us to generate maps of individual element.

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