Microsurgical anatomy of the central lobe

Frigeri, Thomas; Paglioli, Eliseu; Oliveira, Evandro de; Rhoton, Albert L.

doi:10.3171/2014.11.jns14315

Cited by 31 publications

(31 citation statements)

References 56 publications

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“…Sarmento et al [18] stated that the distance between the coronal suture and the central sulcus ranged from 5 to 6.6 cm, in accordance to measurements of Gusmão et al [11] and Ribas et al [12] in the adult. Further, Frigeri et al [19] reported that the precentral gyrus and central sulcus are closest at a point near where the superior temporal line crossed the coronal suture. Further, at this point all the branches of the middle meningeal artery ran posterior to the coronal suture.…”

Section: Discussionmentioning

confidence: 99%

Localization of the bregma and its clinical relevance

Solmaz

2018

Anatomy

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Objectives: External landmarks on the skull are important guides in various neurosurgical procedures. The localization of the bregma is vitally important in bedside ventriculostomy and craniotomies. The aim of the current study was to verify the localization of the bregma. Methods: This was performed on dry skulls (n=72) and sagittal computerized tomography (CT) images of patients (n=100). The age and the sex of dry skulls were unknown. Of the 100 patients, 48 were males and 52 were females and the mean age for males was 51.14 and for females was 55.34. The distance between nasion to inion and nasion to bregma were measured from both dry skulls and on multiplanar reformation (MPR) sagittal images. The ratio of the two measurements was calculated. Results: The nasion to bregma distances on 72 dry skulls ranged between 120-140 mm: the average distance was 124.3±6.9 mm. The nasion to inion distance ranged between 295-345 mm; the average was 320.8±14.4 mm. The ratio of nasion to bregma distance to nasion to inion distance was calculated as 0.384. The nasion to bregma distance obtained from 100 CT images scans ranged from 107 to 139 mm (average 126.6±7.3) mm. The nasion to inion distances ranged between 301 and 356 (average 330.2±15.2) mm. The ratio of nasion to bregma distance to nasion to inion distance was calculated as 0.383. Measurements for females were lower than males, but there was no statistical significance between genders. The multiplication of the nasion to inion distance by 0.38 gave the location of bregma for both genders. Conclusion: An accurate and reliable ratio (0.38 times the distance from nasion to inion) was obtained to define the bregma. The coronal suture lay on each side of bregma, so knowing the exact localization of bregma and of the coronal suture can be vitally important in various surgical procedures to the cranium.

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Section: Discussionmentioning

confidence: 99%

Localization of the bregma and its clinical relevance

Solmaz

2018

Anatomy

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“…Some highly important cortical regions, such as the central lobe and Broca's area, should be avoided . The precentral gyrus, the site of the primary motor cortex, is also to be avoided . In planning for a target near the fornix, most straight paths started from the precentral gyrus, while feasible curved paths provided entry points in the superior and medial frontal gyrus.…”

Section: Discussionmentioning

confidence: 99%

“…27 The precentral gyrus, the site of the primary motor cortex, is also to be avoided. 28 In planning for a target near the fornix, most straight paths started from the precentral gyrus, while feasible curved paths provided entry points in the superior and medial frontal gyrus. Thus, most straight paths for targeting the fornix are rejected, making our approach of interest for providing safe paths to this region.…”

Section: Discussionmentioning

confidence: 99%

3D path planning for flexible needle steering in neurosurgery

Hong

Boehler

Moser

et al. 2019

Robotics Computer Surgery

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Background: We propose a 3D path planning method to steer flexible needles along curved paths in the context of deep brain stimulation (DBS) procedures. Methods: Our approach is based on a rapidly exploring random tree strategy, and it takes into account constraints coming from anatomical obstacles and physical constraints dictated by flexible needle kinematics. The strategy is evaluated in simulation on a realistic 3D CAD model of the brain. Results: The subthalamic nucleus (STN) and the fornix can be reached along several curved paths from various entry points. As compared with the usual straight line path, these curved paths avoid tissue damage to important neural structures while allowing for a much greater selection of entry points. Conclusions: This path planning method offers alternative curved paths to reach DBS targets with flexible needles. The method potentially leads to safer paths and additional entry points capable of reaching the desired stimulation targets.

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“…The many variations of the sylvian veins consist of superficial and deep sylvian veins, which are three-dimensionally anastomosed with the tributaries from the frontal, temporal, parietal lobes, and the insula. [ 2 6 ] The superficial sylvian vein (SSV) is located on the surface of the sylvian fissure, which is like an entrance into the deep brain area. The sacrifice of the tributaries when entering SSV may potentially cause a catastrophic venous infarction.…”

Section: Introductionmentioning

confidence: 99%

Safe and accurate sylvian dissection with the use of indocyanine green videoangiography

et al. 2016

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Background:Sylvian dissection is an essential microneurosurgical skill for neurosurgeons. The safe and accurate opening of the sylvian fissure is desirable for a good prognosis.Methods:The aim of this report is to demonstrate the use of indocyanine green (ICG) videoangiography to recognize the superficial sylvian vein (SSV) and thus enable a wide opening of the sylvian fissure, especially in patients with subarachnoid hemorrhage (SAH).Results:The small tributary flowing into the SSV was distinguishable from a passing one, which deeply entered the insula. In addition, an entering point of a tributary to the SSV, which ran perpendicular to the insula, was occasionally determined. SSV, which was barely discernable in a reddish SAH involving the sylvian fissure, was clearly demarcated using ICG videoangiography. Two representative cases of sylvian dissection are herein presented.Conclusion:The performance of ICG videoangiography before sylvian dissection is a simple and useful method for identifying a vital approach route for safe and accurate sylvian dissection, and it reduces the risk of causing any accidental injury to the veins in the sylvian fissure.

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Microsurgical anatomy of the central lobe

Cited by 31 publications

References 56 publications

Localization of the bregma and its clinical relevance

Localization of the bregma and its clinical relevance

3D path planning for flexible needle steering in neurosurgery

Safe and accurate sylvian dissection with the use of indocyanine green videoangiography

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