Microsurgical anatomy of the interpeduncular cistern and related arachnoid membranes

Lü, Junchang; Zhu, Xianli

doi:10.3171/jns.2005.103.2.0337

Cited by 39 publications

(28 citation statements)

References 9 publications

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“…Kunz et al (2008) argued that it was possible to determine the clinical outcome by assessing the state of the neurovascular structures and the thickness of the FTV if MRIs in 3D-CISS (constructive interference in steady-state) sequence were obtained before endoscopic TV. Endoscopic ventriculostomy in patients with obstructive hydrocephalus is safe and mostly successful, and 3D-CISS MRI seems to be a valuable diagnostic tool for precisely identifying the anatomy of relevant structures such as Liliequist's membrane (Fushimi et al, 2003;Lü and Zhu, 2005). Furthermore, 3D-CISS MRI allows us to judge the thickness of the third ventricle floor and Liliequist's membrane, as well as visualize the ventriculostomy and cerebrospinal fluid flow into the interpeduncular region.…”

Section: Discussionmentioning

confidence: 99%

“…A thorough knowledge of interventional demonstrative cadaveric anatomy in the region is important for avoiding surgical complications. Microsurgical anatomy of the third ventricle and anatomy of the surrounding interpeduncular cistern have been studied by numerous researchers, although a simulation of the procedure using a cadaveric model has not been carried out (Gray, 1918;Marinkovic and Gibo, 1993;Rhoton, 2002;Lü and Zhu, 2005;Fushimi et al, 2006;Froelich et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Anatomy of the floor of the third ventricle in relation to endoscopic ventriculostomy

et al. 2009

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Neuroanatomical structures that form the floor of the third ventricle (FTV) and neighboring tissues are important in the context of third ventriculostomy (TV) procedures. Thorough knowledge of the anatomical and histological organization of the region would be useful in understanding and preventing surgical complications. Taking the third ventricle region as a model, we aimed to simulate TV and make measurements of 23 cadaver brains, as well as perform histological examinations of the third ventricular floor on five cadaver brains. During the endoscopic TV, we examined the degree to which the structures surrounding the FTV were affected by surgical simulation. To make a clinical comparison, the distance between the center of the FTV and the basilar apex was measured on cranial magnetic resonance images (MRIs) of 15 subjects with normal ventricular systems and 15 subjects with moderately enlarged ventricles. Histological examination revealed that the ependymal cells and arachnoid membrane formed the inner and outer surfaces of the third ventricle floor, respectively, whereas the stroma was made up of glial cells exclusively. This region was gliotic and avascular. When cadaver brains with normal and hydrocephalic ventricles were compared, there were significant differences in the distance between the center of the floor and the basilar apex (P < 0.001). On the basis of our study, the optimal site for TV fenestration and balloon inflation is just anterior to the mamillary bodies to avoid injury to neighboring structures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anatomy of the floor of the third ventricle in relation to endoscopic ventriculostomy

et al. 2009

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“…The diencephalic leaf of the Liliequist membrane is attached to the infundibulum and pituitary stalk and to the mammillary bodies, is connected by thick arachnoid trabeculas to the bifurcation of the basilar artery, the precommunication part posterior cerebral arteries, with free edge of the diencephalic-mesencephalic leaf of Liliequist membrane which is in turn connected by arachnoid trabeculas to posterior communicating arteries, superior cerebellar arteries, the posterior perforated substance, and forms walls of the oculomotor cistern (14). The region of the subarachnoid space anterior and posterior to the diencephalic leaf can only communicate through the narrow space between the free superior margin of the diencephalic leaf, the optic tract, and the mesial surface of the temporal lobe, and through the gap around the PCoA in cases where it penetrates the diencephalic leaf (10). Thus, fenestrating the diencephalic leaf of the Liliequist membrane to create a total opening in the interpeduncular cistern may greatly increase the flow of CSF into the prepontine cistern, which is extremely important in the ETV procedure.…”

Section: Etus V Et Al: Ultrastructural Changes In the Liliequist Memmentioning

confidence: 99%

“…Three segments of the Liliequist membrane have been defined; namely sellar, diencephalic, and mesencephalic (10). Among these, the diencephalic leaf represents special interest for the endoscopic surgeon.…”

Section: Etus V Et Al: Ultrastructural Changes In the Liliequist Memmentioning

confidence: 99%

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Ultrastructural changes in liliequist membrane in hydrocephalic process and its implications for endoscopic third ventriculostomy procedure

Etüş¹,

Solakoğlu²,

Ceylan³

2011

Turkish Neurosurgery

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AIm: Fenestration of Liliequist membrane (LM) during endoscopic third ventriculostomy (ETV) is extremely important for the success of the procedure. It is noteworthy that LM usually shows a tough and dense stucture in long-standing hydrocephalus cases different from its usual arachnoidal membrane-like structure observed in new-onset hydrocephalus cases. The structural variation of LM in different hydrocephalic states was investigated histologically in this study. mAterIAl and methOds: Specimens of LM obtained during endoscopic fenestration in 11 cases were examined under transmissionelectron-microscopy. Six cases had long-standing hydrocephalus and five had new-onset triventricular hydrocephalus. None of the cases had a history of infection or hemorrhage. results:In cases with long-standing hydrocephalus, ultrastructural examinations revealed the existence of regular and dense bundles of type-I collagen among the fibroblast-like cells, which were closely connected by dense desmosomes and gap-junctions. In cases with newonset hydrocephalus, it was observed that the cells usually had long cytoplasmic extentions and were connected with loose desmosomes. Sparse type-I collagen bundles were observed rarely among the cells. COnClusIOn:These results suggest that the structure of LM may change with the duration of the hydrocephalic process. This may help explain the tough and dense LM stucture observed during the ETV procedure in cases with long-standing-hydrocephalus.KeywOrds: Endoscopic third ventriculostomy, Hydrocephalus, Liliequist membrane, Transmission electron microscopy ÖZ AmAÇ: Endoskopik üçüncü ventrikülostomi (ETV) işleminde Liliequist membranının (LM) açılması, ETV başarısı açısından kritik öneme sahiptir. LM'nın özellikle uzun süreli hidrosefali olgularında, yeni gelişen hidrosefali olgularına kıyasla daha dirençli ve kalın yapıda oluşu dikkat çekicidir. Yazıda farklı hidrosefali süreçlerinde gözlenen bu yapısal farklılığın histolojik düzeyde incelenmesi amaçlanmıştır. yÖntem ve GereÇ: ETV uygulanan 11 olguda LM açılması sırasında elde edilmiş olan membran parçaları transmisyon elektron mikroskopisinde incelenmiştir. Olguların altı tanesinde "uzun süreli hidrosefali", beşinde ise "yeni başlangıçlı hidrosefali" sözkonusu olup, hiçbirinde geçirilmiş enfeksiyon veya kanama öyküsü yoktu.BulGulAr: Uzun süreçli hidrosefalinin sözkonusu olduğu olgulardan alınan dokularda fibroblast morfolojisi sergileyen hücrelerin arasında düzenli ve yoğun demetler halinde tip I kollajenin varlığı dikkat çekti. Kollajen demetleri arasındaki hücrelerin sık desmozomlar ve gap junctionlar aracılığıyla bağlantılı oldukları görüldü. Yeni başlangıçlı hidrosefali olgularına ait örneklerde ise hücrelerin uzun sitoplazmik uzantılara sahip oldukları ve seyrek desmozomlar aracılığıyla bağlantılı olmalarının yanısıra aralarında nadiren seyrek tip I kollajen lifleri bulunduğu dikkat çekti.sOnuÇ: Bu bulgular, LM'nın hidrosefalinin süresine bağlı olarak fibrozitesinin artması yönünde bir yapısal değişiklik içerisine girdiğini düşündürm...

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Subarachnoid Space

Mortazavi¹,

Adeeb²,

Rizq³

et al. 2016

Bergman's Comprehensive Encyclopedia of Human Anatomic Variation

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Microsurgical anatomy of the interpeduncular cistern and related arachnoid membranes

Cited by 39 publications

References 9 publications

Anatomy of the floor of the third ventricle in relation to endoscopic ventriculostomy

Anatomy of the floor of the third ventricle in relation to endoscopic ventriculostomy

Ultrastructural changes in liliequist membrane in hydrocephalic process and its implications for endoscopic third ventriculostomy procedure

Subarachnoid Space

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