Anatomical Study of the Arachnoid Envelope Over the Pineal Region

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons7-ons15 ◽  
Author(s):  
Qi Song-tao ◽  
Zhang Xi-an ◽  
Fan Jun ◽  
Huang Guang-long ◽  
Pan Jun ◽  
...  
Keyword(s):  
Anterior Part ◽  
Posterior Part ◽  
Anatomical Study ◽  
Pineal Region ◽  
Growth Patterns ◽  
Cerebral Veins ◽  
Vein Of Galen ◽  
Arachnoid Membrane ◽  
Pineal Tumors ◽  
Neurovascular Structures

Abstract BACKGROUND: The distribution of the arachnoid membrane and its relationship with the neurovascular structures in the pineal region are still not fully understood. OBJECTIVE: Because the arachnoid membrane has an intimate relationship with the neurovascular structures in the pineal region and it will always be encountered surgically, we attempted to clarify the formation and distribution of the arachnoid envelope over the pineal region (AEPG). METHODS: The formation and distribution of the AEPG and its relationship with the neurovascular structures in the pineal region were examined by anatomic dissection in 20 adult cadaveric formalin-fixed heads. RESULTS: The supratentorial and infratentorial outer arachnoid membranes converged at the tentorial apex and then embraced and ran forward along the vein of Galen to form the AEPG. The AEPG could be divided into 2 parts. Typically, the posterior part of the AEPG enveloped the vein of Galen and the terminal segments of its tributaries, and the anterior part of the AEPG enveloped the suprapineal recess, the pineal gland, and the distal segment of the internal cerebral veins. The compartment demarcated by the AEPG did not communicate with the adjacent subarachnoid cisterns or space. CONCLUSION: Previous knowledge about the AEPG, as well as the superior boundary and the contents of the quadrigeminal cistern, needs to be revised. The arrangement and individual variation of AEPG are important for a better understanding of the various growth patterns of the pineal tumors and the relationship between the tumor and the neurovascular structures in the pineal region.

scholarly journals Interhemispheric transcallosal intervenous approach to a pineal region tumor

2021 ◽  
Vol 5 (1) ◽  
pp. V11
Author(s):  
Daniel A. Donoho ◽  
Guillermo Aldave
Keyword(s):  
Extent Of Resection ◽  
Pineal Region ◽  
Cerebral Veins ◽  
Surgical Morbidity ◽  
Pineal Tumors ◽  
Pineal Region Tumor ◽  
Pineal Region Tumors ◽  
Transcallosal Approach ◽  
Formidable Challenge ◽  
The Right

Pineal region tumors represent a formidable challenge to the neurosurgeon. Choosing the right approach is key to optimizing the extent of resection and minimizing surgical morbidity. In this video, the authors show an interhemispheric transcallosal approach to a pineal region tumor in a 15-year-old boy. The advantage of this corridor over posterior approaches is that it provides a nice view of the tumor plane with the venous complex, especially while dissecting tumor from the anterior aspect of the internal cerebral veins on their vertical path. Thus, this approach represents a safe and effective alternative for selected pineal tumors. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2120.

scholarly journals Intraventricular Tumor: An Analysis of 18 Cases

2016 ◽  
Vol 13 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Shamsul Alam ◽  
Abu NW Uddin ◽  
Mashiur R Majumder ◽  
Md M Hasan ◽  
Anis Ahmed
Keyword(s):  
Anterior Part ◽  
Third Ventricle ◽  
Posterior Part ◽  
Foramen Of Monro ◽  
Intraventricular Tumors ◽  
Piecemeal Resection ◽  
Neurovascular Structures ◽  
Tumor Debulking ◽  
Neurosurgical Techniques ◽  
Transcortical Approach

The main objective of this article is to describe transcallosal and transcortical approach to deal with intraventricular tumors.Details of the transcallosal and transcortical approach to intraventricular tumors of the lateral and third ventricles were presented.Intraventricular tumors are ideal indications for microscopic neurosurgery. They often cause cerebrospinal fluid (CSF) pathway obstruction, resulting in ventricular dilatation. The general principle of removal of intraventricular tumors is interruption of the blood supply to the tumor and subsequent tumor debulking. In general, a piecemeal resection was performed; however, in some tumors such as meningioma, it was possible to detach the lesion from the surrounding brain tissue and remove it in toto. When the tumor arised in the anterior part of the third ventricle, the craniotomy was made at the coronal suture. When the tumor is located in the posterior part, the entry craniotomy was selected more anteriorly in order to pass the foramen of Monro in a straight line.Intraventricular tumors and related CSF pathway obstructions can be safely and effectively treated with micro neurosurgical techniques, either by transcallosal or transcortical approach. The aim should be the total extraction of the tumor with minimum damage and the chosen operative corridor should optimize tumor access and the protection of vulnerable neurovascular structures. Lateral ventricle tumors can be removed via transcortical approach when having hydrocephalus which provides a wider and more direct approach to the tumor than the transcallosal one. It allows the surgeon to achieve good functional outcome and maximum excision of the tumor. Transcallosal is an excellent midline exposure with preserving the callosomerginal and pericallosal arteriesto the midline tumor of lateral and 3rd ventricles.Nepal Journal of Neuroscience 13:23-29, 2016

Microsurgical Anatomy of the Venous Drainage of the Mesencephalodiencephalic Junction

Neurosurgery ◽  
2004 ◽  
Vol 54 (3) ◽  
pp. 678-686 ◽  
Author(s):  
Patrick Chaynes
Keyword(s):  
Third Ventricle ◽  
Posterior Part ◽  
Pineal Region ◽  
Pineal Body ◽  
Cerebral Vein ◽  
Cerebral Veins ◽  
Microsurgical Anatomy ◽  
Jugular Veins ◽  
Topographic Anatomy ◽  
Adjacent Structures

Abstract OBJECTIVE The veins draining the posterior wall of the third ventricle and its adjacent structures and the posterior part of the midbrain have been the most neglected of the intracranial vascular structures in both the anatomic and neurosurgical literature. During our dissections of the pineal region and the quadrigeminal cistern, we did not always encounter topographic anatomy as described in previous articles. The purpose of this study is to describe the topographic anatomy and normal variations of the specific veins that drain the collicular plate and the pineal body and their adjacent structures with a view to better defining neurosurgical approaches to the pineal region. METHODS The deep cerebral veins draining the pineal body, the collicular plate, and their surrounding neural structures were examined on both sides of 25 adult cadaveric brains. In all specimens, the carotid and vertebral arteries and the jugular veins were perfused with red or blue silicone, respectively, to facilitate dissection under ×3 to ×40 magnification. RESULTS The venous plexus on the dorsal aspect of the collicular plate drains via collicular veins according to three different patterns. These types of drainage are closely related to the existence or absence of the basal vein on one or both sides. CONCLUSION The veins draining the superior and inferior aspects of the pineal body form a superior and an inferior pineal vein that usually drain into the internal or great cerebral vein.

scholarly journals Intraventricular Tumor: An Analysis of 18 Cases

2015 ◽  
Vol 31 (2) ◽  
pp. 94-101
Author(s):  
Shamsul Alam ◽  
AN Wakil Uddin ◽  
Mashiur Rahman Majumder ◽  
Md Motasimul Hasan ◽  
Anis Ahmed
Keyword(s):  
Anterior Part ◽  
Third Ventricle ◽  
Posterior Part ◽  
Foramen Of Monro ◽  
Straight Line ◽  
Intraventricular Tumors ◽  
Piecemeal Resection ◽  
Neurovascular Structures ◽  
Tumor Debulking ◽  
Transcortical Approach

Objective: To describe the transcallosal and transcortical approach to deal with intraventricular tumors. Methods: Details of the transcallosal and transcortical approach to intraventricular tumors of the lateral and third ventricles were presented. Results: Intraventricular tumors are ideal indications for microscopic neurosurgery. They often cause cerebrospinal fluid (CSF) pathway obstruction, resulting in ventricular dilatation. The general principle of removal of intraventricular tumors was interruption of the blood supply to the tumor and subsequent tumor debulking. In general, a piecemeal resection was performed; however, in some tumors such as meningioma, it was possible to detach the lesion from the surrounding brain tissue and remove it in toto. When the tumor found in the anterior part of the third ventricle, the craniotomy was done at the coronal suture. When the tumor was located in the posterior part, the entry craniotomy was selected more anteriorly in order to pass the foramen of Monro in a straight line. Conclusion: Intraventricular tumors and related CSF pathway obstructions can be safely and effectively treated with micro neurosurgical techniques, either by transcallosal or transcortical approach. The aim should be the total extraction of the tumor with minimum damage and the chosen operative corridor should optimize tumor access and the protection of vulnerable neurovascular structures. Lateral ventricle tumors can be removed via transcortical approach when having hydrocephalus which provides a wider and more direct approach to the tumor than the transcallosal one. It allows the surgeon to achieve good functional outcome and maximum excision of the tumor. Transcallosal is an excellent midline exposure with preserving the callosomerginal and pericallosal arteriesto the midline tumor of lateral and 3rd ventricles. Bangladesh Journal of Neuroscience 2015; Vol. 31 (2): 94-101

Microsurgical anatomy of the great cerebral vein of Galen and its tributaries

2003 ◽  
Vol 99 (6) ◽  
pp. 1028-1038 ◽  
Author(s):  
Patrick Chaynes
Keyword(s):  
Venous Drainage ◽  
Pineal Region ◽  
Surgical Approaches ◽  
Cerebral Vein ◽  
Cerebral Veins ◽  
Microsurgical Anatomy ◽  
Vein Of Galen ◽  
Content Type ◽  
Deep Cerebral Veins ◽  
Fine Print

Object. The deep cerebral veins may pose a major obstacle in operative approaches to deep-seated lesions, especially in the pineal region where multiple veins converge on the great cerebral vein of Galen. Because undesirable sequelae may occur from such surgery, the number of veins and branches to be sacrificed during these approaches should kept to a minimum. The purpose of this study was to examine venous drainage into the vein of Galen with a view to surgical approaches. If a vein hampering surgical access must be sacrificed, it can therefore be selected according to the smallest draining territory. Methods. The deep cerebral veins and their surrounding neural structures were examined in 50 cerebral hemispheres from 25 adult cadavers in which the arteries and veins had been perfused with red and blue silicone, respectively. Special consideration was given to the size and location of drainage of the vein of Galen and its tributaries. Conclusions. When a surgeon approaches the pineal region, several veins may hamper the access route. From posterior to anterior, these include the following: the superior vermian and the precentral or superior cerebellar veins, which drain into the posteroinferior aspect of the vein of Galen; and the tectal and pineal veins, which drain into its anterosuperior aspect. The internal occipital vein is the main vessel draining into the lateral aspect of the vein of Galen. It may be joined by the posterior pericallosal vein, and in that case has an extensive territory. To avoid intraoperative venous infarction, it is important to use angiography to determine the venous organization before surgery and to estimate the permeability and size of the branches of the deep venous system.

scholarly journals Two cases of pineal-region meningiomas derived from arachnoid membrane over the vein of Galen without dural attachment

2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Akihiro Inoue ◽  
Takanori Ohnishi ◽  
Shohei Kohno ◽  
Yoshihiro Ohtsuka ◽  
Yawara Nakamura ◽  
...  
Keyword(s):  
Pineal Region ◽  
Vein Of Galen ◽  
Arachnoid Membrane ◽  
Dural Attachment

An electrophysiological and anatomical study of projections to the mouse cortical barrelfield and its surroundings

1985 ◽  
Vol 53 (3) ◽  
pp. 686-698 ◽  
Author(s):  
J. C. Nussbaumer ◽  
H. Van der Loos
Keyword(s):  
Anterior Part ◽  
Posterior Part ◽  
Anatomical Study ◽  
Nerve Fibers ◽  
Hair Follicles ◽  
Natural Stimulation ◽  
Whisker Pad ◽  
The Common ◽  
Cortical Map ◽  
Stimulation Of

This study establishes a cortical map of the somatosensory periphery of the mouse head, with emphasis on the whisker pad. Data in the literature on the projection of the common hair follicles are confusing, notably the question whether or not this projection is separated from or overlaps with that of the facial vibrissae, the barrelfield. Microelectrode recordings in the barrelfield and its immediate surroundings upon natural stimulation of the periphery were followed by microlesions and histological reconstruction. Results show that the barrelfield consists of two parts: an anterior part where vibrissal follicles and the skin bearing them are represented, and a posterior part receiving only vibrissa inputs. The skin between these latter vibrissae is represented outside the barrelfield. We conclude that the partially dissociated cortical representation of skin and vibrissae may allow large vibrissae to be used in tasks requiring greater acuity than the shorter ones provide. This hypothesis is supported by the observation that, owing to special muscles, large vibrissae are more mobile than short ones. We also propose that the segregation of inputs from vibrissae and common fur is related to the number of nerve fibers serving one follicle, and we indicate an experimental model to test this possibility.

Anterior interhemispheric transsplenial approach to pineal region tumors: anatomical study and illustrative case

2018 ◽  
Vol 128 (1) ◽  
pp. 182-192 ◽  
Author(s):  
Kaan Yağmurlu ◽  
Hasan A. Zaidi ◽  
M. Yashar S. Kalani ◽  
Albert L. Rhoton ◽  
Mark C. Preul ◽  
...  
Keyword(s):  
Corpus Callosum ◽  
Anatomical Study ◽  
Pineal Region ◽  
Venous System ◽  
Illustrative Case ◽  
Cerebral Veins ◽  
Pineal Region Tumors ◽  
Deep Venous System ◽  
Surgical Corridor ◽  
Occipital Lobes

Pineal region tumors are challenging to access because they are centrally located within the calvaria and surrounded by critical neurovascular structures. The goal of this work is to describe a new surgical trajectory, the anterior interhemispheric transsplenial approach, to the pineal region and falcotentorial junction area. To demonstrate this approach, the authors examined 7 adult formalin-fixed silicone-injected cadaveric heads and 2 fresh human brain specimens. One representative case of falcotentorial meningioma treated through an anterior interhemispheric transsplenial approach is also described. Among the interhemispheric approaches to the pineal region, the anterior interhemispheric transsplenial approach has several advantages. 1) There are few or no bridging veins at the level of the pericoronal suture. 2) The parietal and occipital lobes are not retracted, which reduces the chances of approach-related morbidity, especially in the dominant hemisphere. 3) The risk of damage to the deep venous structures is low because the tumor surface reached first is relatively vein free. 4) The internal cerebral veins can be manipulated and dissected away laterally through the anterior interhemispheric route but not via the posterior interhemispheric route. 5) Early control of medial posterior choroidal arteries is obtained. The anterior interhemispheric transsplenial approach provides a safe and effective surgical corridor for patients with supratentorial pineal region tumors that 1) extend superiorly, involve the splenium of the corpus callosum, and push the deep venous system in a posterosuperior or an anteroinferior direction; 2) are tentorial and displace the deep venous system inferiorly; or 3) originate from the splenium of the corpus callosum.

Microsurgery of the Third Ventricle: Part 1

Neurosurgery ◽  
1981 ◽  
Vol 8 (3) ◽  
pp. 334-356 ◽  
Author(s):  
Isao Yamamoto ◽  
Albert L. Rhoton ◽  
David A. Peace
Keyword(s):  
Lateral Ventricle ◽  
Anterior Part ◽  
Third Ventricle ◽  
Posterior Part ◽  
Posterior Wall ◽  
Pineal Region ◽  
Circle Of Willis ◽  
Cerebral Vein ◽  
Foramen Of Monro ◽  
3Rd Ventricle

Abstract The 3rd ventricle is one of the most surgically inaccessible areas in the brain. It is impossible to reach its cavity without incising some neural structures. Twenty-five cadaveric brains were examined in detail to evaluate the surgically important relationships of the walls of the 3rd ventricle. The routes through which the 3rd ventricle can be reached are: (a) from above, through the foramen of Monro and the roof after entering the lateral ventricle through the corpus callosum or the cerebral cortex; (b) from anterior, through the lamina terminalis; (c) from below, through the floor if it has been stretched by tumor; and (d) from posterior, through the pineal region or from the posterior part of the lateral ventricle through the crus of the fornix. The posterior part of the circle of Willis and the basilar artery are intimately related to the floor, the anterior part of the circle of Willis and the anterior cerebral and anterior communicating arteries are related to the anterior wall, and the posterior cerebral artery supplies the posterior wall. The deep cerebral venous system is intimately related to the 3rd ventricle; the internal cerebral vein is related to the roof, and the basal vein is related to the floor. The junction of these veins with the great vein forms a formidable obstacle to the operative approach to the pineal gland and the posterior part of the 3rd ventricle.

scholarly journals Meningioma of the pineal region: a surgical series of 10 cases

1996 ◽  
Vol 85 (4) ◽  
pp. 586-590 ◽  
Author(s):  
Alexander Nikolaevich Konovalov ◽  
Aldo Spallone ◽  
David Iraklevich Pitzkhelauri
Keyword(s):  
Venous Occlusion ◽  
Pineal Region ◽  
Cerebral Veins ◽  
Tumor Removal ◽  
Pineal Tumors ◽  
Content Type ◽  
Internal Cerebral Veins ◽  
Microsurgical Approach ◽  
Quadrigeminal Plate ◽  
Total Tumor Removal

✓ Ten cases of meningioma of the pineal region were histologically verified at a single institution during an 8-year period. These represented 0.3% of 3061 intracranial meningiomas, as well as 6.2% of 164 pineal tumors. Patients were predominantly women. Symptoms and signs of increased intracranial pressure were most common, whereas Parinaud's syndrome was observed in only one case. Computerized tomography (CT) was the main diagnostic test used in the present series. It usually revealed a hyperdense mass with high-intensity contrast enhancement and a calcified mass eccentrically located at the periphery, which returned to its central location postsurgically and was likely to represent a calcified pineal gland. Magnetic resonance imaging was performed in the more recent cases and confirmed the suspicion raised by CT of a meningioma with a calcified mass at its periphery. Surgery was performed using an occipital transtentorial microsurgical approach with the patient placed in the semisitting position. Gross-total tumor removal was achieved in all cases, although this required sacrifice of the vein of Galen in six patients. Venous occlusion was performed only after adequate intraoperative verification of functional occlusion and blood flow diversion from the galenic system and had no consequences in any case but one. This latter patient had an infiltrative meningioma that was removed at the expense of intraoperative sacrifice of the two internal cerebral veins, as well as unavoidable trauma to the region of the quadrigeminal plate. All the remaining patients improved postsurgery, and only one had a permanent visual field deficit as a result of the surgical approach. Pineal meningiomas represent a rare subgroup of pineal tumors that can be treated surgically with reasonably good results. Sacrifice of major basal veins may be required to achieve radical tumor removal and can be tolerated by the patient provided that functional occlusion of the galenic system, as indicated by preoperative angiography, is verified during surgery.

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