The Lamina Terminalis represents an important neuroanatomical structure by which third Ventriculostomy could be performed into the subarachnoid space through the Cisterna Chiasmatica. Recent studies have indicated a role for Lamina Terminalis fenestration in approaching pathologies of the third ventricle. However, there is limited knowledge on the anatomical features, variations and the vasculature of the Lamina Terminalis in a Zambian population. This study was aimed to explore the anatomy of the Lamina Terminalis, the Cisterna Chiasmatica and its neurovascular relationships as seen in a Zambian population and compare with the findings in the literature. The study was a descriptive cross-sectional design in which 32 post-mortem human cadaveric brains were systematically sampled. The Lamina Terminalis region was examined in 27 male cadavers and five female cadavers of age range between 25 and 66 years (mean 34.1 ± 9.2years). Data was collected using a data collection form, entered and analyzed by descriptive statistics using Statistical Package for Social Sciences (SPSS) software version 22. Mean and standard deviations were used to describe variables. The base of the brain was detached from the floor of the cranial cavity and the Lamina Terminalis exposed fully by retracting both optic nerves and the optic Chiasma posteroinferiorly. Thetriangular Lamina Terminalis measurements were performed as the distance between the midportion of the upper aspect of the chiasma and the lower aspect of the anterior commissure (height), which averaged 8.6 ±1.0mm. The distance between the medial edges of the optic tracts (base) averaged 13.1 ±1.1mm and the area averaged 56.9 ± 11.6mm2. The Lamina Terminalis membrane showed variations in appearance; 20 were transparent with a large dark midline gap and 10 were less translucent with a slender midline gap and two were indistinct. The Cisterna Chiasmatica was observed as a dilated subarachnoid space adjacent to the Optic Chiasma. For neurovascular relationships, 24 cadavers showed arterioles arising from the posterosuperior aspect of the anterior cerebral artery to perforate the anterior perforating substance(s), supplying the chiasma, and optic tracts; whereas, eight cadavers showed arterioles arising posteroinferiorly and ramifying on the Lamina Terminalis. The Lamina Terminalis membrane is variably developed. There are variations in the membrane appearance, measurements and neurovascular relationships. These findings will supplement a knowledge gap in neuroanatomy and help prevent complications during Lamina Terminalis fenestration in approaching pathologies of the third ventricle.Key words: Lamina Terminalis, Cisterna Chiasmatica, Third Ventriculostomy
Vertebral artery is an important source of blood supply to the brain which arises from the subclavian arteries. Anatomical variations have been incidentally reported during autopsy and angiograms. These variations predispose to development of aneurysms, dissections and may lead to vertebrobasilar ischaemia and posterior circulation stroke. Knowledge of variations of the great vessels of the neck is important for endovascular interventionists and diagnostic radiologists, more so in the era of new therapeutic options for intracranial interventions. Forty-two computerised tomography angiograms at the University Teaching Hospitals, Radiology Department Lusaka were examined to investigate vertebral artery variations in a Zambian population and determine the origin of the vessels. These paired vessels were examined thoroughly individually. Eighty-four arteries were examined eighty one (96.4%) had origin from the subclavian artery while three (3.6%) left took origin from the aortic arch. Variations found were two (2.4%) right vertebral arteries had fenestrations, ten (11.9%) had dual origin and one (1.2%) left was hypoplastic. The age ranged from 18 and 81 with mean age of (42.5±) of these seven females and four males had variations. Demographic characteristic (gender and age) had no statistically significant association to variations of vertebral artery (P>0.05). Variations of the vertebral artery are common. Knowledge of these variations is important and helpful in preventing iatrogenic injuries and haemorrhage during endovascular intervention and diagnostic procedures.Keywords: Vertebral artery, duplication, fenestrations, hypoplasia
The main source of blood supply to the gall bladder is the cystic artery which is a branch of the right hepatic artery. Anatomical variations of the cystic artery are frequent. Thus, careful dissection of the Calot`s triangle is necessary for conventional and laparoscopic cholecystectomy. The knowledge of variations of the origin, course, and length of the cystic artery is important for the surgeon as bleeding from the cystic artery during cholecystectomy can lead to death. Thirty-two post-mortem human cadavers at the University Teaching Hospitals, Pathology Department, Lusaka were dissected and examined over a period of five weeks, to establish the origin, length and course of the cystic artery. And to establish the relationship of the cystic artery to the cystic duct. Out of the 32 human cadavers, the cystic artery was found to be originating from the right hepatic artery in twenty-eight (87.5%), from hepatic artery proper in three (9.4%) and from the left hepatic artery in one (3.1%). In the twenty-nine (90.6%) cadavers dissected, only one cystic artery was identified and in three (9.4%)others there were two arteries detected. The cystic artery length ranged from 2 – 6 cm (mean 3.56± 1.0285 cm). The cystic artery was found to be inside Calot`s triangle in twenty-seven (84.3%) while in three (9.4%) cadavers it was outside the Calot`s triangle. The cystic artery was found to be passing supero-medial to the cystic duct in thirty (93.7%) cadavers while in two (6.3%) the cystic artery was passing anterior to the cystic duct. Demographic characteristic (gender and age) had no statistically significant association to variations of cystic artery (p>0.005). Five (18.5%) of males had variants of cystic artery and no females had variants of the cystic artery. Variations of the cystic artery origin, length, its course through the Calot`s triangle and its relation to the cystic duct are common. Knowledge of these variations is important and helpful in preventing and controlling haemorrhage or avoiding other complications during conventional and laparoscopic cholecystectomy. Key words: Cystic artery, Variations, Cholecystectomy, Calot`s triangle
This article has been retracted by the authors. An incorrect dataset was used, therefore the resullts are misleading.The main source of blood supply to the gall bladder is the cystic artery which is a branch of the right hepatic artery. Anatomical variations of the cystic artery are frequent. Thus, careful dissection of the Calot`s triangle is necessary for conventional and laparoscopic cholecystectomy. The knowledge of variations of the origin, course, and length of the cystic artery is important for the surgeon as bleeding from the cystic artery during cholecystectomy can lead to death. Forty-three post-mortem human cadavers at the University Teaching Hospitals, Pathology Department, Lusaka were dissected and examined over a period of five weeks, to establish the origin, length and course of the cystic artery. And to establish the relationship of the cystic artery to the cystic duct. Out of the 43 human cadavers, the cystic artery was found to be originating from the right hepatic artery in 37 cases (86%), from hepatic artery proper in four cases (9.3%), from the left hepatic artery in one case (2.3%) and liver parenchyma in one case (2.3%). In the forty (93%) cadavers dissected, only one cystic artery was identified and in three (7%) others there were two arteries detected. The cystic artery length ranged from 2 – 6 cm (mean 3.53± 0.962 cm). The cystic artery was found to be inside Calot`s triangle in 37 cases (86%) while in four cases (9.3%) it was outside the Calot`s triangle. The cystic artery was found to be passing supero-medial to the cystic duct in 40 cases (93%) while in two cases (4.7%) the cystic artery was passing anterior to the cystic duct and one (2.3%) was unrelated (from the gall bladder bed) to the cystic duct. Demographic characteristic (gender and age) had no statistically significant association to variations of cystic artery (p>0.005). Six (16.2%) of males had variants of cystic artery and no females had variants of the cystic artery. Variations of the cystic artery origin, length, its course through the Calot`s triangle and its relation to the cystic duct are common. Knowledge of these variations is important and helpful in preventing and controlling haemorrhage or avoiding other complications during conventional and laparoscopic cholecystectomy.Keywords: Cystic artery, Cholecystectomy, Calot`s triangle
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