Knowledge of anatomical variations in the peripheral nervous system is key in the interpretation of unusual clinical signs or during physical or diagnostic imaging. This case study is a description of an anatomical variation between the coracobrachialis muscle and brachial plexus. In a routine dissection in the human anatomy laboratory, we were faced with an anatomical variation in the coracobrachialis muscle, observed in the upper right limb of a male cadaver. The coracobrachialis muscle had a common origin at the apex of the coracoid process and then divided into two heads. The lateral head followed its normal course until insertion into the middle third of the humerus, while the medial head involved the lateral cord of the brachial plexus before insertion into the intermuscular septum in the proximal third of the humerus. Atypical anatomical variations have clinical andsurgical implications in procedures such as brachial plexus block and lateral cord compression. In these cases the result could be paralysis of the flexor musculature of the forearm and hypoesthesia of the forearm. (Folia Morphol 2017; 76, 4: 762-765)

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OBJECTIVE The cerebellar interpeduncular region (CIPR) is a gate for dorsolateral pontine and cerebellar lesions accessed through the supracerebellar infratentorial approach (SCITa), the occipital transtentorial approach (OTa), or the subtemporal transtentorial approach (STa). The authors sought to compare the exposures of the CIPR region that each of these approaches provided. METHODS Three approaches were performed bilaterally in eight silicone-injected cadaveric heads. The working area, area of exposure, depth of the surgical corridor, length of the interpeduncular sulcus (IPS) exposed, and bridging veins were statistically studied and compared based on each approach. RESULTS The OTa provided the largest working area (1421 mm2; p < 0.0001) and the longest surgical corridor (6.75 cm; p = 0.0006). Compared with the SCITa, the STa provided a larger exposure area (249.3 mm2; p = 0.0148) and exposed more of the length of the IPS (1.15 cm; p = 0.0484). The most bridging veins were encountered with the SCITa; however, no significant differences were found between this approach and the other approaches (p > 0.05). CONCLUSIONS To reach the CIPR, the STa provided a more extensive exposure area and more linear exposure than did the SCITa. The OTa offered a larger working area than the SCIT and the STa; however, the OTa had the most extensive surgical corridor. These data may help neurosurgeons select the most appropriate approach for lesions of the CIPR.

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