Anatomia microcirúrgica da artéria coróidea anterior

Introduction:Numerical classification systems for the internal carotid artery (ICA) are available, but modifications have added confusion to the numerical systems. Furthermore, previous classifications may not be applicable uniformly to microsurgical and endoscopic procedures. The purpose of this study was to develop a clinically useful classification system.Materials and Methods:We performed cadaver dissections of the ICA in 5 heads (10 sides) and evaluated 648 internal carotid arteries with computed tomography angiography. We identified specific anatomic landmarks to define the beginning and end of each ICA segment.Results:The ICA was classified into eight segments based on the cadaver and imaging findings: (1) Cervical segment; (2) cochlear segment (ascending segment of the ICA in the temporal bone) (relation of the start of this segment to the base of the styloid process: Above, 425 sides [80%]; below, 2 sides [0.4%]; at same level, 107 sides [20%]; P < 0.0001) (relation of cochlea to ICA: Posterior, 501 sides [85%]; posteromedial, 84 sides [14%]; P < 0.0001); (3) petrous segment (horizontal segment of ICA in the temporal bone) starting at the crossing of the eustachian tube superolateral to the ICA turn in all 10 samples; (4) Gasserian-Clival segment (ascending segment of ICA in the cavernous sinus) starting at the petrolingual ligament (PLL) (relation to vidian canal on imaging: At same level, 360 sides [63%]; below, 154 sides [27%]; above, 53 sides [9%]; P < 0.0001); in this segment, the ICA projected medially toward the clivus in 275 sides (52%) or parallel to the clivus with no deviation in 256 sides (48%; P < 0.0001); (5) sellar segment (medial loop of ICA in the cavernous sinus) starting at the takeoff of the meningeal hypophyseal trunk (ICA was medial into the sella in 271 cases [46%], lateral without touching the sella in 127 cases [23%], and abutting the sella in 182 cases [31%]; P < 0.0001); (6) sphenoid segment (lateral loop of ICA within the cavernous sinus) starting at the crossing of the fourth cranial nerve on the lateral aspect of the cavernous ICA and located directly lateral to the sphenoid sinus; (7) ring segment (ICA between the 2 dural rings) starting at the crossing of the third cranial nerve on the lateral aspect of the ICA; (8) cisternal segment starting at the distal dural ring.Conclusions:The classification may be applied uniformly to all skull base surgical approaches including lateral microsurgical and ventral endoscopic approaches, obviating the need for 2 separate classification systems. The classification allows extrapolation of relevant clinical information because each named segment may indicate potential surgical risk to specific structures.

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“…Classification of this segment has been provided in detail previously[22632353738394041424344] [Table 3]. …”

Section: Discussionmentioning

confidence: 99%

Proposed clinical internal carotid artery classification system

Abdulrauf

Ashour

Marvin

et al. 2016

J Craniovert Jun Spine

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“…18,19 Vascularization of the STN The STN is irrigated by the anterior chorioidea arteries, branches of the internal carotid artery, which emerges just above the origin of the posterior communicating artery. 20 The drainage system is of the deep venous type. Through this, the deep cerebral veins, which flow into the internal cerebral vein, drain to the magna vein.…”

Section: Afferent and Efferent Stn Fibersmentioning

confidence: 99%

“…Through this, the deep cerebral veins, which flow into the internal cerebral vein, drain to the magna vein. 20 Neuropathological Considerations Related to the STN Clinical studies of the Luys' STN emerged in 1884, when Ralph Canfield and James J. Putnam presented one of the first case reports of hemiballism. 2 This fact was evidenced in the literature in the study by Martin (1927), apud Parent et al, 2 which reviewed the world literature and found that 11 of the 12 patients previously reported with hemiballism presented lesions in the STN area, including two with lesions restricted to this, in addition to a case reported by the researcher himself of a small hemorrhage almost limited to the STN.…”

Section: Afferent and Efferent Stn Fibersmentioning

confidence: 99%

Subthalamic Nucleus: Neuroanatomical Review

Magalhães¹,

Reis

Sousa

et al. 2017

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Palavras-Chaves► núcleo subtalâmico ► vias eferentes ► coreia ► doença de Parkinson ResumoDescoberto em 1865 por Jules Bernard Luys, o núcleo subtalâmico (NST)é um conjunto de pequenos núcleos situados no diencéfalo, inferior ao tálamo e superior à substância negra, que pode ser visualizado em um corte coronal posterior. Histologicamente, consiste em neurônios distribuídos de forma compacta e preenchidos com um grande número de vasos sanguíneos e fibras mielinizadas dispersas. Esta revisão apresenta uma análise sobre essa região anatômica, considerando o que há na literatura a seu respeito. Os neurônios subtalâmicos são excitatórios e utilizam o glutamato como neurotransmissor. Em indivíduos saudáveis, esses neurônios são inibidos por células nervosas localizadas no globo pálido lateral. Contudo, se as fibras que compõem o circuito paleoestriado forem lesadas, os neurônios tornam-se altamente excitáveis, provocando assim distúrbios motores que podem ser classificados como: hiperciné-ticos, tais como balismo e coreia, ou hipocinéticos, por exemplo, doença de Parkinson (DP). O advento da estimulação cerebral profunda tem concedido grande visibilidade ao NST. Estudos destacam que a estimulação desse núcleo realmente ameniza os sintomas motores da doença de Parkinson. AbstractDiscovered in 1865 by Luys, the subthalamic nucleus is a set of small nuclei located in the diencephalon, inferior to the thalamus and superior to the substantia nigra, that can be visualized in a posterior coronal section. Histologically, it consists of neurons compactly distributed and filled with large numbers of blood vessels and sparse myelinated fibers. This review presents an analysis of this anatomical region, considering what is most recent in the literature. Subthalamic neurons are excitatory and use glutamate as the neurotransmitter. In healthy individuals, these neurons are inhibited by nerve cells located in the side globus pallidus. However, if the fibers that make up the afferent circuit are damaged, the neurons become highly excitable, thus causing motor disturbances that can be classified as hyperkinetic, for example ballism and chorea, or

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Visual Pathway

Remington

2012

Clinical Anatomy and Physiology of the Visual System

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Anatomia microcirúrgica da artéria coróidea anterior

Cited by 6 publications

References 18 publications

Proposed clinical internal carotid artery classification system

Proposed clinical internal carotid artery classification system

Subthalamic Nucleus: Neuroanatomical Review

Visual Pathway

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